Sin Duda: A Community-Driven Approach to Expand Reach, Access and Uptake of COVID-19 Home-Based Tests for At-Risk Latinos

The COVID-19 pandemic disproportionately impacts Latinos in the US. COVID-19 testing remains critical for tracking and slowing the spread of the virus and preventing future outbreaks, particularly in communities disproportionately affected by COVID-19 and where vaccination coverage is suboptimal. The goal of this project was to expand the RADx-UP Phase 1 COVID-19 testing project "Vive Sin Duda" to implement and evaluate innovative implementation strategies to increase reach, access, and uptake of COVID-19 home-based self-testing (HST) among low-income Latinos in Maryland. This study implemented and evaluated two distribution approaches: 1) Network-based; and 2) Social marketing. The study also incorporated data driven iterative changes to optimize a community health worker (CHW)-led short message service (SMS) platform to support HST and linkage to COVID-19 care, vaccination, and other services (e.g., cash and food assistance). Primary and secondary outcomes include: 1) Reach and uptake of HST; and 2) Linkage to care for those who test positive or vaccination for unvaccinated people who test negative. Leveraging existing community coalition, testing and vaccination clinics, and a team of bilingual and bicultural CHWs, the team was well poised to implement a COVID-19 HST program and measure its impact. The research provided important new information to improve access and uptake of innovative COVID-19 testing technology. It also filled critical knowledge gaps to guide the translation of evidence-based interventions into widespread adoption by RADx-UP consortium members.