Evaluating a Community-Led COVID-19 Testing Intervention to Address Mistrust

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Project Summary Our preliminary work with low-income Black residents in Southeastern and Central Virginia suggests that preexisting mistrust in the public health establishment and other important government institutions has worsened during the pandemic, affecting decision making about following public health guidance related to COVID-19 testing and vaccination. In particular, participants in our current study report that a major barrier to COVID-19 testing is the expectation that a positive result will be used against them. This suggests that trust- building must be a cornerstone of any COVID-19 outreach efforts. The goal of this proposal is to address these concerns through the development of a community-led intervention co-developed with our partner Housing Collaborative Community Advisory Board (HC CAB). Our HC CAB partners report that our relationships with them helped overcome mistrust common in their communities. They described the way we interacted with them, rather than any specific content, led us to be viewed as trustworthy. Engagement with a strong relationship building focus is thus likely an important intervention in and of itself—in this study we will standardize a process of relationship and trust building to be used as core components of a community-led intervention promoting rapid COVID-19 testing. In Aim 1 we administer and evaluate a preliminary virtual Peer Mentor COVID-19 testing intervention developed with our HC CAB partners. It uses a Peer Mentor model in which HC CAB members guide other community members participating in the study through self-administering a rapid in-home test. The process will be virtual, with HC CAB member Peer Mentors and participants using digital access capacity provided and supported by the research team. In a second arm of the study participants will meet with research staff in group sessions meant to approximate the experience of being a member of a community advisory board. There will also be a control group which will only receive follow up assessment. In Aim 2 we use evaluation data to develop an adapted COVID-19 testing intervention. In Aim 3 we administer the adapted intervention.