Adapting Community-Based Task-Shifting for the COVID-19 Response Among Underserved Populations in Piedmont, North Carolina (ACT UP)

In North Carolina and nationally, Black and Hispanic/Latinx communities have been disproportionately affected by COVID-19 due to multi-level risk factors and barriers to testing, prevention, and care, but have not benefited from a clinical and public health response commensurate with the magnitude of the problem. To address this, a proven implementation strategy from the global HIV response community-based task shifting was adapted to reach underserved and vulnerable Black and Hispanic/Latinx communities with COVID-19 testing and linkage to care, vaccination, and other preventative measures in rural central North Carolina, and to evaluate the effects of this strategy on important health service and implementation outcomes. This project improved testing access for underserved communities being missed by current testing approaches, and generated new insights into a promising implementation strategy that could be leveraged to enhance ongoing pandemic response efforts and delivery of COVID-19 vaccines and other prevention interventions.