The health and economic effects of the COVID-19 pandemic in the United States are staggering, and persons of color in the US ? already heavily impacted by structural inequities ? bear a disproportionate burden of COVID-19 disease and death. Testing is a cornerstone of stopping the spread of the virus, yet in the US testing rates remain far below target levels and current strategies are failing to reach the communities most affected. In California, despite initial success in limiting spread with the earliest shelter-in-place mandate in the nation, even partial attempts at easing restrictions have resulted in a surge in new cases. Currently, California has the highest case count in the U.S and the pandemic is taking a disproportionate toll on Latinx individuals, many of whom are essential workers. An incomplete understanding of testing barriers and optimal strategies to mitigate these barriers among Latinx persons hampers the design of the scalable strategies needed to accelerate equity in the reach, uptake, and preventative impact of SARS CoV-2 testing throughout the US. In this proposal, our objective is to evaluate community-engaged approaches to scale low-barrier COVID-19 testing for Latinx communities and evaluate retesting strategies for priority groups in Latinx communities at increased risk of infection. We will draw upon our experience with Latinx community-engaged mass SARS- CoV2 testing campaigns, expertise in community-based HIV testing trials informed by behavioral economics and the success of San Francisco?s Latinx Task Force for COVID-19 model.
In Aim 1, we will evaluate implementation of a Latino Task Force (LTF) collaborative network across 3 counties in Northern California (Marin, Merced and San Francisco), adapted from San Francisco?s LTF model to promote locally-adapted COVID-19 test and respond initiatives in two majority-Latinx communities: one suburban (Marin) and one rural (Merced).
In Aim 2, we will determine the population-level prevalence of active (PCR+) SARS-CoV-2 infection, most at-risk subgroups, and attitudes and preferences of community members regarding COVID-19 testing services during baseline mass testing campaigns at the Marin and Merced sites. The campaigns will offer testing to all community residents regardless of symptoms at easily accessible venues, implemented in partnership with each site?s LTF.
In Aim 3, we will conduct a 3-arm randomized controlled trial (RCT) to determine the comparative effectiveness of two behavioral strategies ? one that leverages incentives (extrinsic motivation) and another that relies on altruism framing (intrinsic motivation) compared to standard offer of retesting (control) ? to increase frequent SARS-CoV-2 retesting among most at-risk sub-groups (identified during Aim 2 campaigns) within the study communities. The proposed research will provide critical data to inform scalable testing strategies, reduce transmission, decrease health disparities, and set the stage for future, biomedical interventions, such as vaccines.

Public Health Relevance

The COVID-19 pandemic is having devastating health and economic effects globally and disproportionately affecting Latinx/Hispanic and Black/African American communities across the US that were already heavily impacted by health inequities prior to the pandemic. This study aims to implement and evaluate community- engaged approaches to improving access and uptake of COVID-19 testing in Latinx communities in Northern California, and understanding local epidemiology and factors driving the stark ethnic disparities observed in COVID-19 case rates.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Center Core Grants (P30)
Project #
3P30AI027763-29S1
Application #
10233730
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Refsland, Eric William
Project Start
2020-10-21
Project End
2022-08-31
Budget Start
2020-10-21
Budget End
2021-08-31
Support Year
29
Fiscal Year
2021
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
Ayers, Leona W; Barbachano-Guerrero, Arturo; McAllister, Shane C et al. (2018) Mast Cell Activation and KSHV Infection in Kaposi Sarcoma. Clin Cancer Res 24:5085-5097
Tang, Weiming; Liu, Chuncheng; Cao, Bolin et al. (2018) Receiving HIV Serostatus Disclosure from Partners Before Sex: Results from an Online Survey of Chinese Men Who Have Sex with Men. AIDS Behav 22:3826-3835
Clutton, Genevieve Tyndale; Jones, R Brad (2018) Diverse Impacts of HIV Latency-Reversing Agents on CD8+ T-Cell Function: Implications for HIV Cure. Front Immunol 9:1452
Tamraz, Bani; Huang, Yong; French, Audrey L et al. (2018) A Genome-Wide Association Study Identifies a Candidate Gene Associated With Atazanavir Exposure Measured in Hair. Clin Pharmacol Ther 104:949-956
Jiang, Wei; Luo, Zhenwu; Martin, Lisa et al. (2018) Drug Use is Associated with Anti-CD4 IgG-mediated CD4+ T Cell Death and Poor CD4+ T Cell Recovery in Viral-suppressive HIV-infected Individuals Under Antiretroviral Therapy. Curr HIV Res 16:143-150
Kattah, Michael G; Milush, Jeffrey M; Burt, Trevor et al. (2018) Anti-TNF and thiopurine therapy in pregnant IBD patients does not significantly alter a panel of B-cell and T-cell subsets in 1-year-old infants. Clin Transl Gastroenterol 9:143
Lidofsky, Anna; Holmes, Jacinta A; Feeney, Eoin R et al. (2018) Macrophage Activation Marker Soluble CD163 Is a Dynamic Marker of Liver Fibrogenesis in Human Immunodeficiency Virus/Hepatitis C Virus Coinfection. J Infect Dis 218:1394-1403
El-Sadr, Wafaa M; Goosby, Eric (2018) Building on the HIV platform: tackling the challenge of noncommunicable diseases among persons living with HIV. AIDS 32 Suppl 1:S1-S3
Dunkley, Emma; Ashaba, Scholastic; Burns, Bridget et al. (2018) ""I beg you…breastfeed the baby, things changed"": infant feeding experiences among Ugandan mothers living with HIV in the context of evolving guidelines to prevent postnatal transmission. BMC Public Health 18:188
Streubel, Gundula; Watson, Ariane; Jammula, Sri Ganesh et al. (2018) The H3K36me2 Methyltransferase Nsd1 Demarcates PRC2-Mediated H3K27me2 and H3K27me3 Domains in Embryonic Stem Cells. Mol Cell 70:371-379.e5

Showing the most recent 10 out of 1541 publications