Building Resilience and Vital Equity (BRAVE) - Increasing COVID-19 Testing in American Indians

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Abstract The COVID19 pandemic continues to hit hardest on underserved communities including American Indians (AI)/Alaska Natives (AN). Diseases with significant health disparities and social determinants of health are major risk factors and define COVID19 related disparities among AI/AN. Increased testing and upcoming adherence to vaccination recommendations are two important strategies to manage COVID19 and mitigate the impact of the virus on marginalized communities. Mounting evidence indicates that underserved communities are less likely to actively participate in mass testing and immunization recommendations due to poverty, access, inadequate information, logistics and issues surrounding fear, stigma and trust. North Carolina (NC) has the largest AI population east of the Mississippi River and the sixth largest AI population in the nation with more than half living in rural underserved counties of Robeson, Scotland, Hoke and Cumberland. This proposal is a partnership between two community engaged academic institutions (North Carolina Central University - NCCU and University of North Carolina at Pembroke-UNCP) and a major community partner – The Lumbee Tribe of North Carolina (LTNC) with 62,500 members. We hypothesize that a bidirectional community- engaged approach to understand the social ethical and behavioral implications (SEBI) combined with focused interventions to address the barriers will increase testing and mitigate the consequences of COVID-19 in AI communities of NC. The specific aims of the proposal are (1) To understand the barriers and social implications of COVID19 testing among American Indians by designing and implementing culturally sensitive survey tools and intervention materials. (2) Implement BRAVE outreach and testing interventions to increase testing in American Indian community and (3) Data analysis, evaluation and data sharing. BRAVE is a bold community-engaged initiative to increase testing by addressing disparities and building resiliency to change the narrative from struggle to strength in AI community as we fight this unfortunate public health emergency.