RI-Center for Clinical and Translational Science

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SUMMARY Nationally, Latinx individuals have four times the rate of SARS-CoV-2 diagnoses compared to Non- Hispanic Whites. Furthermore, Latinx populations may face barriers in accessing SARS-CoV-2 tests, receiving test results, interpreting test results, and getting appropriate follow-up care. Improved understanding of the sources of health equity differences for Latinx populations can be used to better guide allocation of resources and provide essential data for provider organizations seeking to support those in the most need. This RADx- UP project will establish a statewide research and monitoring infrastructure in partnership with community clinics. We will develop community health teams (“Promotoras Teams”) with the largest Latinx community organization in Rhode Island to address identified barriers to COVID-19 testing through patient navigation, health literacy support, and follow-up care. The overall goals of the proposed study are to improve testing uptake and the understanding of SARS- CoV-2 outcomes among Latinx populations. We will build on partnerships with community clinics that serve a high proportion of Latinx individuals (>50%) in Rhode Island. We will place particular emphasis on disparities in care faced by Latinx populations and factors that have been identified as impacting health equity in Rhode Island (integrated healthcare, community resilience, physical environment, socioeconomics, and community trauma). The insights gained from the quantitative and qualitative approaches will be used to guide the implementation of community campaigns to improve testing among Latinx populations that are in identified locations with lower per capita testing than other parts of the state (“testing deserts”). This RADx-UP project will utilize a unique approach and infrastructure to monitor SARS-CoV-2 testing rates, including the use of the statewide Health Information Exchange (HIE) in Rhode Island that connects data across primary care, urgent care, specialty care, and acute care clinical environments. The HIE contains clinical data for most people receiving care in Rhode Island including SARS-CoV-2 test results from major laboratories and other facilities (e.g., CVS MinuteClinic). These quantitative data will be combined with qualitative data and organized according to the Consolidated Framework for Implementation Research framework to guide our mixed-methods explanatory sequential design. The specific aims of this project are to: (1) Identify COVID-19 hotspots and testing deserts using a near-real time geographic information system monitoring system; (2) Determine community and provider barriers that impact access to SARS-CoV-2 testing; and, (3) Implement community-based approaches to improve SARS-CoV-2 testing. This RADx-UP project will develop a community-based infrastructure to enable structured, longitudinal relationships with a historically underserved patient population. Such insights will provide essential data for a population level decision support system guiding testing prioritization and for future consideration of vaccine-based prevention strategies.