ABSTRACT
This multi-institution team (Emory University, Morehouse School of Medicine, Georgia Institute of Technology),
anchored by the Georgia Center for Diabetes Translation Research (P30DK111024) partnership, proposes
to leverage and expand on the on-going, RADx-UP funded Project PEACH (P30DK111024), to design and
evaluate a home-based COVID-19 testing program with behavioral nudges delivered via mobile phone
texts to increase uptake of COVID-19 prevention activities (testing, vaccination, preventive behaviors) in “An
Adaptive Intervention Trial of Home Testing with Behavioral Nudges for Improving COVID-19 Testing
and Prevention among People Affected by Diabetes.” COVID-19 testing remains a cornerstone in
understanding and managing the COVID-19 pandemic. The state of Georgia faces several challenges to
COVID-19 management including low vaccine rates, over-extended community health partners struggling to
manage both COVID-19 testing and vaccination, decreasing COVID-19 testing numbers, and large populations
at elevated risk, including those with or at risk for diabetes, individuals at lower socioeconomic levels, and
African American/Black and LatinX communities. In Project PEACH2, we propose to leverage the community
partnerships developed and expanded at part of Project PEACH to gather additional information on COVID-19
testing, with a particular focus on at-home testing solutions (Aim 1), using both quantitative (an expansion of
the follow-up surveys already being conducted as part of Project PEACH) and qualitative (in-depth interviews
with 100 community members, key stakeholders, and community partners) methods. This data, along with the
findings of Project PEACH and Georgia CEAL (1OT2HL156812-01/16-312-0217571-66105L), will be used to
develop text message, behavioral nudges to promote continued COVID-19 testing, reporting and preventive
behaviors including vaccination targeted to participants’ race/ethnicity, sex, age, vaccination status, and testing
history. We will then evaluate (Aim 2a) the uptake, usage, and views of a home testing platform (provision a
single home COVID-19 test kit for each household family member, collection of test results via an online
reporting system, and targeted behavioral nudges delivered via text messages) in a randomized community-
based, adaptive intervention trial (n=600) targeting individuals affected by diabetes through collaborations with
community partner sites (faith- and community-based organization, the Grady Diabetes Clinic, COVID-19
community testing and vaccine distribution sites). We will also assess (Aim 2b) how the home testing platform
affects vaccine uptake and hesitancy among study participants and family members. This study will build on
the successful community-academic partnerships created through Project PEACH to further promote COVID-
19 testing among the most vulnerable communities in Georgia. Lessons learned can be disseminated to other
at-risk communities and can be adapted to promote home-based testing for other conditions.