Accelerating Excellence in Translational Science (AXIS) - Administrative Supplement

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SUMMARY/ABSTRACT Underserved and under-resourced African American (AA) communities face two major COVID-19 related challenges during this pandemic. One major challenge, at the community level, is the increased risk of outbreaks of COVID-19 at faith-based gatherings. The second major challenge is the negative impact of this pandemic on the management of chronic conditions, particularly older adults with co-morbidities and underlying conditions. AA older adults, specifically those managing comorbidities and social isolation, are one of the most vulnerable groups susceptible to COVID-19 infection and have the most severe and critical consequences of this pandemic. AA older adults with co-morbidities, who heavily rely on county-based safety- net facilities, have had to change their patterns of seeking required medical care to manage their chronic conditions, including delaying, reducing, or stopping visits to primary and specialty providers, or to a pharmacy to obtain medication and treatment. Reduced routine access to health care providers and prescribed medications, coupled with risky health behaviors during the pandemic, may substantially exasperate existing disparities in healthcare utilization, non-adherence to management of chronic conditions, unhealthy lifestyles, and poorer health outcomes among underserved AA older adults. This multilevel, multidisciplinary, theoretically-based, culturally sensitive, community participatory intervention addresses these challenges in two phases. In Phase One, we collaborate with 10 AA church leaders on implementing Federal and State (California) public health guidelines for churches for reducing COVID-19 risk in predominantly AA churches in South Los Angeles, potentially impacting over 3,000 parishioners. In addition, we collaborate with 10 AA churches to train 30 church-based AA young adults as health advisors to master information about COVID-19 and its impact on the daily life of underserved AAs, particularly, older adults with underlying multimorbidity or social isolation. In Phase Two, we recruit 265 AA older parishioners to receive a telehealth-based culturally and spiritually sensitive intervention that provides health coaching and support. The goal of this phase is to mitigate the negative impact of COVID-19 on the management of chronic health conditions, and to reduce healthcare avoidance behaviors and psychological distress caused by the pandemic. This study builds sustainability for the AA community with the training of 30 AA church-based health advisors who will be a valuable community resource as they can continue to provide coaching and support after the intervention. Through collaboration with AA church leaders in South Los Angeles, we ensure that AA ministerial leaders are at the forefront of our efforts to assist in the development of a healthy community. This intervention seeks to help one of the most vulnerable populations impacted by COVID-19 and is strongly endorsed by the California Black Health Network.