COVID-19: Implementing Community-Based Approaches to Increase SARS-CoV-2 Testing Among an Underserved and Vulnerable Hispanic Population

Hispanics living in the United States have been negatively affected by the COVID-19 pandemic in a disproportionate manner, including significantly higher infection and hospitalization rates compared with non-Hispanic whites. The El Paso, TX metropolitan area has a substantial Hispanic population that has been profoundly affected by the current SARS-CoV-2 pandemic, especially the vulnerable residents of rural El Paso County. Many of these residents suffer from marked cumulative disadvantages with limited healthcare, poor access to public transportation, work as essential workers in low-paying frontline jobs, and demonstrate a persistent hesitancy to interact with unfamiliar medical systems and processes, resulting in "SARS-CoV-2 testing deserts". There is a critical need to increase the number of individuals being tested for SARS-CoV-2 in El Paso County, however, success in this space requires an integrated and personalized approach whereby residents are engaged with and informed by trusted co-ethnics and local organizations. The aims strategically integrated University of Texas at El Paso (UTEP), non-profit, business, and public partners, coupled with culturally-centric familial and Community Health Worker (CHWs) networks, as catalysts to: 1) reduce testing deficiencies by providing SARS-CoV-2 testing information, navigation strategies to testing sites, and implementing local pop-up testing sites, and 2) provide foundational data for understanding testing barriers and developing platforms for assessing future COVID-19 vaccine uptake willingness for El Paso residents. The UTEP Border Biomedical Research Center (BBRC), and associated Coronavirus Testing Program that provides CLIA-certified testing, was central to completion of the integrated approaches, and the established capability of the investigative team to interact with community partners and recruit participants was a prominent strength of the plan. The studies tested the novel hypothesis that improving the reach, acceptance, uptake and sustainability of SARS-CoV-2 testing for the most marginalized populations of El Paso County is dependent on implementing strategies that target the cultural, social and behavioral factors characteristic of this population. The multifaceted approach enhanced the testing capacity in the El Paso region, reduced testing hesitancy, increased coronavirus testing numbers for vulnerable populations within specific testing deserts, and exerted a sustained influence on the health status of the region by integrating the extensive collaborative networks that are essential for addressing the persistent negative social determinants of health.