COVID-19 Large Network Center

Ohio includes a very diverse population, with many minority, underserved, and vulnerable communities (MUVP). The need to increase testing in Ohio's MUVP is great; testing rates are only at 2.0 per 1000, with positivity rates indicating active community spread. With rapidly rising infection rates, ways to curb infection and morbidity/mortality are needed, especially in the most vulnerable populations. The RADx-UP Initiative Large Network proposal, RADx-UP Ohio, leveraged the vast community partnership networks of the Ohio Center for Clinical and Translational Science Award and the OSU Comprehensive Cancer Center to identify reasons for and intervene to reduce disparities in COVID-19 education, testing, contact tracing, follow-up and treatment among MUVP in Ohio in a bi-directional academic-state-community partnership. This complemented the work of Ohio Department of Health (ODH) emergency response to this pandemic. This research process is guided by a socio-ecological model based on the Social Determinants of Health, the Proctor Model for Implementation Science and a Community-Based Participatory Research (CBPR) framework and prior preliminary work of the team, using an implementation science framework and overall program evaluation. The goal of this RADx-UP Large Network Proposal (RADx-UP Ohio) was to address and reduce the disparities in COVID-19 education, testing, contact testing, follow-up and treatment (COVID-19 testing components) among minority, underserved, and vulnerable populations through the delivery of a CBPR-integrated program that focused on individual, social and community health system and broader contextual-level barriers related to disparities in COVID-19 testing components, built upon a long-standing academic-community-government partnership. The specific aims were to: (1) Implement a multi-level intervention, built on effective interventions of the team, to increase the impact of COVID testing in MUVP in 12 selected counties informed by community partner input that will increase uptake of COVID-19 testing, knowledge of COVID-19 testing and results, and follow-up including contact tracing for positives; (2) Assess the impact and sustainability of the intervention in different MUVP in Ohio; and (3) Interact with public health entities to disseminate successful strategies. The interventions were culturally appropriate and tailored to the needs of each MUVP in the 12 selected counties using an implementation science design, with counties randomized in a 3-wave step wedge design. RADx-UP Ohio included the following Units: Community Engagement and Intervention; Testing; Statistics and Data Management; Human Subjects, and Evaluation. RADx-UP Ohio used a hub and spoke model where the units provided expertise to support the activities of the 4 regional teams, each of which included CHWs from each of the 3 individual counties with at least one community stakeholder to provide community context and ensure authentic partnerships are maintained.