Community-Academic Partnerships to Address COVID-19 Inequities within African American Communities

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Abstract In a few months’ time, the emergence of the coronavirus disease (COVID-19), a highly contagious disease resulting from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), sickened millions and killed hundreds of thousands of people in the United States alone. As with many other communicable and non- communicable diseases, African Americans disproportionately bear the burden of elevated rates of COVID-19- related morbidity and mortality. The rise in negative sentiments towards wearing masks in public, interpersonal and structural racism, and inability to shelter-in-place further exacerbate risk of SARS-CoV-2 exposure for members of vulnerable populations, including African Americans. With recent projections estimating that nearly 50,000 more Americans will die of COVID-19-related complications by December 2020, with at least 30% likely to be African American, it is clear that current public health efforts, which are overwhelmingly expert-driven and top-down, are failing. As such, innovative solutions that: 1) empower and equip communities to play an active role in promoting public health and responsiveness, 2) leverage community assets and multisectoral partnerships, and 3) facilitate a sense of unity and collective responsibility are sorely needed if we are to contain SARS-CoV-2 and eliminate COVID-19-related morbidity and mortality, particularly amongst those suffering disproportionately worse outcomes. Public health campaigns and non-pharmaceutical interventions (NPIs) that are community-driven and developed in collaboration with community members, public health agencies, and researchers may offer a more acceptable and effective approach that could enable the US to drastically reduce COVID-19 transmission and address individual and socio-structural barriers that lead to worse COVID-19-related outcomes among African Americans. Our study goals are to use a crowdsourcing contest to identify exceptional ideas that promote COVID-19 testing and encourage the public to adopt health- promotive behaviors. We will then conduct a randomized experiment to examine the impact of the contest on the targeted health-promotive behaviors. Next, in partnership with Project Grace, an academic-community partnership in rural NC, we will initiate an NPI called the Rapid Response Team, which will be a community- based contact tracing and case investigation program that will focus on identifying local COVID-19 infections in their communities, providing assistance and information regarding implementing safety protocols, and meeting existing needs of community members within a rural community in North Carolina by leveraging NCCARE360, a new digital, statewide coordinated care network intended to better connect individuals to local services and resources. Then, we will determine the feasibility, acceptability, and reach of the Rapid Response Team regarding contacting community members and linking them to local resources as needed, increasing COVID- 19 testing, and increasing the practice of the 3Ws among adults in rural, Eastern North Carolina.