dbGaP Study Accession: phs002645

NIH Institute/Center: NINR

RADx Data Program: RADx-UP

DOI: 10.60773/sx9p-ww84

Release Date: 08/31/2023

Updated Date: 04/17/2024

Study Description: The epidemic of novel coronavirus disease 2019 (COVID-19) has caused an unprecedented public health crisis in the United States. African Americans (AA) have been disproportionately impacted, as systemic inequities have contributed to increased exposure and vulnerability to COVID-19. Evidence suggests that AAs are delaying testing and care for COVID-19, which increases risk of transmission and poor outcomes. In Chicago, segregated AA neighborhoods have experienced some of the highest COVID-19 mortality rates in the city, yet large portions of these neighborhoods remain testing deserts. Providing trusted, accessible, community-based testing in underserved AA communities is critical to ensuring that individuals receive an early diagnosis, thereby reducing the risk of further transmission and improving clinical outcomes. This study leveraged the Alive Church Network (ACN), a long-standing, community-driven coalition of African American pastors and public health researchers that was developed as a sustainable infrastructure to address health inequities in chronic disease in segregated AA neighborhoods in Chicago. The ACN was designed to address lack of access to health care, cultural insensitivity, and lack of trust, which are the root cause of disparities in chronic disease as well as infectious disease, including COVID-19. The project utilized the ACN infrastructure to create a network of church-based testing sites in a segregated and underserved AA neighborhood in Chicago that provided COVID-19 testing and education as well as linkage to healthcare and social resources. Thirteen ACN pastors who served predominantly AA congregations in the West Side of Chicago formed a coalition to promote community-wide COVID-19 testing in local churches. Residents of all ages received COVID-19 education and free SARS-CoV- 2 PCR testing with rapid turn-around of results from an on-site clinical team, as well as connection to local resources to address social needs, including food, housing, and medical care. The specific aims of this study were: (1) Conduct a rapid needs assessment to identify barriers to and facilitators of COVID-19 testing to inform a tailored outreach and intervention strategy to increase COVID-19 testing among high-risk AAs; (2 – Primary Aim) Evaluate the impact of the ACN COVID-19 testing intervention on uptake of testing among residents of target high poverty AA neighborhoods in Chicago; (3) Use the RE-AIM framework to assess the reach, adoption, implementation, maintenance and cost of the ACN COVID-19 testing intervention. The primary analysis used an interrupted time series framework, which is a quasi-experimental approach, to test whether the ACN testing intervention was successful at increasing uptake of testing by at least 20% among residents in the target neighborhoods. Completion of these aims provided crucial evidence about the public health utility of this approach and informed efforts to scale this intervention to increase testing uptake in other vulnerable urban areas in Chicago and nationally.

Principal Investigator: Lynch, Elizabeth B

Has Data Files: Yes

Study Domain: Rapid Diagnostic Test (RDT); Community Outreach Programs; Testing Rate/Uptake

Data Collection Method: Molecular (Nucleic Acid/PCR) Testing Device; Survey

Keywords: Faith-based Testing Sites; Testing Disparities; Medical Mistrust; COVID Outreach/Education; Building Trust Amongst Marginalized Communities

Study Design: Time-Series

Multi-Center Study: FALSE

Data Types: Questionnaires/Surveys; Behavioral; Social

Study Start Date: 11/01/2020

Study End Date: 10/31/2022

Species: Human Data

Estimated Cohort Size: 5000

Study Population Focus: African American; Underserved/Vulnerable Population; Children; Older Adults or Elderly; Adults

ClinicalTrials.gov URL: https://clinicaltrials.gov/study/NCT05197452

Acknowledgement Statement: This study was supported through funding, 3R01NR018463-01A1S1, for the National Institute of Nursing Research (NINR) as part of the RADx-UP program. We would also like to thank churches of the Chicago-based Alive Faith Network who served as partners on this project. Approved users should acknowledge the provision of data access by dbGaP for accession phs002645.v1.p1, and the NIH RADx Data Hub. Approved users should also acknowledge the specific version(s) of the dataset(s) obtained from the NIH RADx Data Hub.

Funding Opportunity Announcement (FOA) Number: PA-20-135

NIH Grant or Contract Number(s): 3R01NR018463-01A1S1

Consent/Data Use Limitations: General Research Use