Abstract
Background: Home-based testing for COVID-19 has potential to reduce existing health care disparities among underserved populations in the United States. However, implementation of home-based tests in these communities may face significant barriers. This study evaluates the acceptability, feasibility, and success of home-based testing and the potential added benefit of active support from trusted community health workers for Native Americans and Hispanic/Latino adults living in rural Montana and Washington states.
Methods/design: The academic-community research team designed the trial to be responsive to community needs for understanding barriers and supports to home-based COVID-19 testing. The “Protecting Our Community” study is a two-arm pragmatic randomized controlled trial in which a total of 400 participants are randomized to active or passive arms. Participants of both study arms receive a commercially available home collection COVID-19 test kit, which is completed by mailing a self-collected nasal swab to a central laboratory. The primary study outcome is return of the kit to the central lab within 14 days. The cultural, social, behavioral, and economic barriers to home-based COVID-19 testing are also assessed by qualitative research methods. A survey and semi-structured interviews are conducted after the trial to evaluate perceptions and experience of home-based testing.
Discussion: Implementing home-based testing in underserved populations, including among Native American and Hispanic/Latino communities, may require additional support to be successful. The Protecting Our Community trial examines the effect of trusted community health workers on use of home-based testing, which may be adaptable for community-driven models of home-based testing in other underserved populations.
Keywords: COVID-19; Community health worker; Home-based testing; Latino; Native American; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, SARS-CoV-2., Community health worker, Home-based testing, Latino, Native American, 【초록키워드】 Randomized controlled trial, Trial, feasibility, outcome, Population, Laboratory, Randomized, Health, COVID-19 testing, implementation, Research, Community, nasal swab, Care, community health, Pragmatic, health worker, COVID-19 test, Washington, Support, ARMS, participant, Two-arm, The United States, Arm, lab, populations, benefit, evaluate, conducted, added, reduce, American, receive, Community trial, economic barrier, Implementing, Native, Protecting, 【제목키워드】 randomized trial, Pragmatic, Native,