SCALE-UP Utah: Community-Academic Partnership to Address COVID-19 Among Utah Community Health Centers

Background: The purpose of this study was to address the disproportionate impact of COVID-19 on racial and ethnic minority groups, low socioeconomic status populations, and rural communities in Utah. Latino residents represented about 14 percent of the state population but accounted for roughly 40 percent of COVID-19 cases, with case rates more than three times higher in high-deprivation neighborhoods. Similar disparities were seen among Pacific Islander, African American, and Native American populations. Community Health Centers (CHCs) served as critical access points for underserved populations, including individuals who were uninsured, living in poverty, or residing in rural or frontier areas. SCALE-UP Utah aimed to increase equitable reach, uptake, and sustainability of COVID-19 screening and testing by leveraging existing infrastructure, long-standing partnerships, and health information technology systems across 12 CHC systems and 39 clinics.

Materials/Methods: This statewide pragmatic study implemented three multilevel interventions within CHCs to increase COVID-19 screening and testing uptake. Interventions were grounded in population health management strategies and relied on widely available tools including point-of-care health information technology, text messaging outreach, and patient navigation. The study used rapid-cycle research methods to test interventions on small scales over short intervals, evaluate their effects, refine them, and then disseminate successful strategies across additional clinics. Participating CHCs served more than 115,000 patients annually, including high proportions of Latino and Native American patients, individuals living below the federal poverty level, uninsured individuals, and residents of rural communities. Data collection focused on testing uptake, clinic characteristics, patient characteristics, and implementation outcomes.

Outcome/Impact: Rapid-cycle testing identified approaches that clinics could implement and adapt quickly, improving both reach and uptake. The work enhanced statewide coordination, strengthened data networks, and built infrastructure that supported future public health responses, including vaccination efforts. Findings advanced implementation science and provided a framework for other low resource healthcare settings seeking to expand access to testing and reduce COVID-19 disparities.