Connecting our Neighborhoods Need for Enhanced and Coordinated Testing to Achieve Equity: CoNNECT to Achieve Equality

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ABSTRACT COVID-19 infections, hospitalizations, and deaths are disparate across racial and ethnic groups in the United States (US), disproportionately impacting minority communities. Northwest Arkansas (Washington and Benton Counties) is a “COVID-19 Hot Spot” in the US, with the region reporting such stark racial/ethnic disparities related to COVID-19 that the Centers for Disease Control and Prevention (CDC) came to Northwest Arkansas to investigate in June and July 2020 and then the National Institutes of Health sent investigators in early August 2020. The CDC's July 2020 report documented that 45% of all adult cases in Northwest Arkansas were among Hispanic/Latinx patients and 19% were Native Hawaiian/Pacific Islander (NHPI) patients. Hispanic/Latinxs and NHPIs, only account for 17% and 2.4% of the two-county population, respectively. COVID-19 deaths in Northwest Arkansas were also disparate across race and ethnicity. NHPI deaths were estimated to be more than 200 per 100K —much higher than the overall death ratio for the county of 5.10 per 100K, as well as the death ratio for Whites of 4.03 per 100K. There is an urgent need to increase COVID-19 testing and prepare for future vaccination trials, especially for the NHPI and Hispanic/Latinx communities of Northwest Arkansas. The uptake of current testing is low, less than 5%, and our needs assessment found the top preferred locations identified were clinics with drive-through testing and drive-through testing in targeted housing complex and neighborhood. We will use a community-based participatory research approach guided by the Social Ecological Model (SEM) to target testing strategies that will have the greatest impact. Our specific aims are: Aim 1: leverage and fully engage our long-standing community-based partnerships to increase COVID-19 testing and prepare for future vaccination trials; Aim 2: implement and evaluate access and uptake strategies of two community-driven COVID-19 testing approaches to understand effectiveness and impact for vulnerable populations; Aim 2a: evaluate which testing sites are most effective in reaching specific vulnerable populations based on age, race/ethnicity, and sex; Aim 2b: examine how social determinants of health influence testing behaviors and preferred testing location; Aim 2c: conduct an implementation study to document facilitators and barriers to implementation of community-based testing methods; and Aim 3: fully collaborate with the RADx-UP Coordinating and Data Collection Center (CDCC) and other RADx-UP sites. The proposed study aims are built directly on our collaborative needs assessment and recommendations from our Community and Scientific Advisory Board (CSAB). Our current infrastructure and partnerships have been sustained for more than seven years and have been highly productive across multiple projects through local, institutional, and federal support. We are confident that we can leverage these partnerships to address COVID- 19 mitigation efforts, including potential vaccine, and/or therapeutic implementation efforts.