Implementing an evidence-based health literacy approach to address COVID-19 among racially and ethnically diverse communities in Providence, Rhode Island - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the Coronavirus Disease 2019 (COVID-19) pandemic. In the United States, COVID-19 disproportionately impacts marginalized and underserved populations including Black/African American (B/AA) and Hispanic/Latinx (H/L) communities1,2. Improving health literacy, the degree to which individuals are able to find, understand, and use information and services to inform health-related decisions, is critical to address the social determinants of health3 and improve COVID-19 related outcomes in these groups. The overall goal of the proposed project is to implement evidence-based health literacy strategies that are culturally appropriate to enhance COVID-19 mitigation measures including testing, vaccination, and infection control (e.g., masking, physical distancing, and hand hygiene) among B/AA and H/L communities in Providence, Rhode Island. At the time of submission, Rhode Island had the third highest cases of COVID-19 per capita and the fourth highest rate of deaths due to COVID-19 per capita in the United States. Rhode Island has among the widest disparities in COVID-19 outcomes in the nation. Providence is the major urban center in Rhode Island, with a population of approximately 180,000 people. The population of Providence is 42% H/L and 16% B/AA and has a high Social Vulnerability Index (SVI) in the top 4th. B/AA individuals have five times the rate of SARS-CoV-2 seroprevalence as Whites and H/L individuals have nine times the seroprevalence as Whites4. The specific objectives of the project are to: 1) Develop evidence-based, culturally congruent health literacy interventions to enhance COVID-19 mitigation measures among B/AA and H/L populations; 2) Implement evidence-based, culturally congruent health literacy interventions to enhance COVID-19 mitigation measures among B/AA and H/L populations; and 3) Evaluate evidence-based, culturally tailored health literacy interventions
to enhance COVID-19 mitigation measures among B/AA and H/L populations. The approach will include a comprehensive, citywide, culturally tailored media and social marketing campaign, as well as clinic- and community-level interventions to improve health literacy among B/AA and H/L communities. The proposed project brings together the major clinical organizations across the city that serve B/AA, H/L, and other diverse populations, as well as the City of Providence Healthy Communities Office. Evaluation will be led by Tougaloo College (Jackson, Mississippi), with whom the project team has a decade-long history of collaboration. Staff from Tougaloo College will evaluate a set of specific, measurable, achievable, relevant, and time-bound (SMART) outcomes, including number of individuals offered COVID-19 testing and vaccination, number of individuals who accepted COVID-19 testing and vaccination, increase in community members’ health literacy scores, and number of community members reached by the citywide health literacy media campaign. The proposed project aligns with the overall HHS Strategic Plan and Healthy People 2030 objectives. Our track record reaching underserved populations, including B/AA and H/L communities, and our culture of continuous quality improvement, will inform implementation models that can be disseminated to other sites. The results of this project will provide important insights on reaching communities at highest risk for acquiring COVID-19.
