PROJECT SUMMARY/ABSTRACT
Cases of COVID-19 infection in San Diego have persistently remained high in the county’s central and southern
communities near the US/Mexico border, home to primarily Latino residents who have been one of the ethnic
minority communities most impacted by COVID-19. To address this, our Phase I RADx-UP project partnered
with San Ysidro Health (SYH), a federally qualified health center, and the Global Action Research Center (Global
ARC), a social change organization, to co-create and demonstrate the impact of a PCR-based COVID-19 testing
program in San Ysidro. To date, we have administered approximately 15,000 PCR tests for >10,000 community
members (92% Latino) and received requests from SYH to scale-out the testing program to additional primary
care clinic sites. Responsive to RFA-OD-22-006, we will continue working with our community (Global ARC) and
clinical (SYH) partners to refine, specify, implement, and evaluate an implementation strategy bundle that
optimizes COVID-19 testing, expanding beyond current PCR testing to focus on FDA-authorized COVID-19 rapid
antigen testing. Use of self-administered rapid antigen tests will allow participants to build capacity to self-test
and use health information technology to access additional clinic services. Based on initial implementation
mapping with the project’s established Community and Scientific Advisory Board, three implementation
strategies were prioritized to accelerate sustained uptake of rapid COVID-19 testing. These three strategies
include: (1) current, walk-up onsite free testing; (2) promotores-led COVID-19 test counseling and preventive
care reminders; (3) vending machines that dispense FDA-authorized self-testing kits. Our primary objectives are
to: 1) refine and operationalize our multi-component implementation strategy bundle and a related set of
measures of success for rapid FDA- authorized COVID-19 testing and 2) implement and evaluate impact of our
innovative, multilevel, and multicomponent implementation strategy bundle to optimize COVID-19 rapid testing
among underserved, Latino communities using a roll-out implementation optimization study design across four
clinics over 18 months. The COVID-19 pandemic has underscored the urgent and essential need to engage
invested community parties continuously and meaningfully in public health research to reduce health disparities.
This proposal is well-positioned to provide a set of strategies and measures of success that can be used in
settings serving underserved communities while maintaining flexibility to adjust to the changing COVID-19
landscape.
