Dataset from Improving the Response of Local Urban and Rural Communities to Disparities in COVID-19 Testing

Background: The purpose of this study was to examine the effectiveness of a regional learning collaborative of health departments designed to reduce COVID-19 testing inequities in communities disproportionately affected by the pandemic. Local health departments had used widely varying strategies, and learning collaboratives had shown value in helping groups share solutions and implement interventions consistently. Building on preliminary success from a community-led model in Wyandotte County, Kansas, the study formed Local Health Equity Action Teams in 10 counties to rapidly adapt, test, and implement community-driven solutions to COVID-19 testing disparities.

Materials/Methods: This pragmatic, hybrid type II trial used a diverse, multi-jurisdictional learning collaborative known as the Community Partner Program. Local Health Equity Action Teams from four urban and six rural counties received training and resources to support COVID-19 testing equity. Supported interventions included community-sponsored pop-up testing events, home-based and worksite testing options, community-informed communication strategies, and support packages for at-risk individuals and families undergoing testing. Additional locally proposed or nationally identified interventions within RADx-UP were continuously reviewed and incorporated. Semi-structured interviews and surveys were conducted within each county to identify subgroup-specific barriers and facilitators to testing. Epidemiologic surveillance tools were used to develop county-level metrics of testing inequities. Guided by the RE-AIM framework and the Consolidated Framework for Intervention Research, the study assessed testing uptake, reach, adoption, implementation, and maintenance of intervention components across all participating communities.

Outcome/Impact: The study advanced understanding of how learning collaboratives support equitable COVID-19 testing by sharing best practices across jurisdictions and enabling rapid adaptation of community-driven strategies. Results provided evidence for a scalable framework that local health departments could use to respond to COVID-19 testing gaps and future public health emergencies, including challenges related to COVID-19 vaccination in underserved populations.