Optimizing SARS-CoV-2 Testing and Promotores Interventions to Serve Latinx Communities

This study will test, compare, and determine if targeted placement of testing events at venues identified each month as viable by the Oregon Health Authority, Community Based Organizations, and our community partners ("partner-optimized venue placement strategy") will increase the number of Latinx individuals who get tested. All testing events will receive the Promotores de Salud intervention, which includes Spanish/English bilingual community health workers (i.e., promotores) from the local communities delivering health information to everyone attending testing events.

Promotores will deliver the Promotores de Salud intervention and promote strategies that are effective in mitigating the spread of COVID-19. They will also emphasize the continued importance of preventive strategies given the increasing availability of vaccines and addressing vaccine hesitancy. This health information will be shared at testing events via brief verbal interactions and printed materials (i.e., brochures and infographics). The intervention will also specifically address logistical challenges associated with vaccination uptake (e.g., lack of transportation, language barriers, and difficulty locating vaccination opportunities), which are additional factors driving vaccine hesitancy among Latinx communities. The Promotores de Salud intervention was designed to build relationships with Latinx community members and facilitate trust.

To assess the proportion of Latinx community members tested at each site, the investigators will use de-identified health information from a patient registry provided to the study by the University of Oregon's (UO) COVID-19 clinical genomics laboratory, who are processing the tests. The investigators anticipate engaging a greater proportion of Latinx community members, relative to overall county demographics, at the testing events. The investigators also expect to enroll more proportionally more Latinx individuals as these events, relative to Phase I events. The overall study population is expected to be 75% Hispanic and 25% non-Hispanic, with 87% of individuals identifying as White in both ethnic groups and the remaining 13% identifying as African American, Asian, Pacific Islander, American Indian/Alaska Native, or more than one race. The investigators anticipate testing approximately 100 people per month, across 11 months and 24 events, for a total of 1,100 individuals tested. To assess health behaviors, a subset of adult participants at each testing event will be invited to participate in a research survey, administered at testing (baseline) and again 30 days later (T2). Of the 1,100 individuals tested, the team anticipates that 50% will choose to participate in the research survey for a total of 550 individual participants. Survey data from baseline to T2 will be used to examine the effectiveness of the promotores intervention, as a function of intervention fidelity.

Quality Assurance, Data Checks, Source Data Verification, Data Dictionary, and Standard Operating Procedures: Data and biospecimens will be collected in-person at testing sites, requiring direct interaction with participants. In order to report SARS-CoV-2 infection results back to each participant, name, date of birth, and contact information are collected. To fulfill reporting requirements to the Oregon Health Authority, county of residence and zip code are also collected for each person tested. Data used to evaluate the efficacy of intervention will involve aggregate variables derived from data collected as part of the diagnostic testing procedure and will be aggregated at the level of the testing site (e.g., tests performed, race and ethnicity percentages, etc.).

For the collection of SARS-CoV-2 samples, testing facilitators will guide participants in the self-collection process. For anterior nares, participants are instructed to place the nasal swab about 1cm into their nostril and rotate it, making contact with the nasal membrane for 10 seconds, then repeating the process with the same swab in the other nostril. Testing site staff can assist participants who have low dexterity or physical impairments in sample collection. In case of an injury during sample collection, the partnering community organization staff will direct the participant to the appropriate medical resources. Samples will be placed into sterile barcoded vials (1 ml Matrix, barcoded screw-cap tubes) that each contain 500 microliters (μl) of DNA/RNA Shield. Each Matrix tube will then be closed tightly and will be placed in a standard plastic laboratory microcentrifuge tube rack with eight rows and twelve columns (8-by-12 rack with 96 positions). This rack will then be externally decontaminated by brief submersion in accelerated hydrogen peroxide (H202). Each 96-position microcentrifuge tube rack will then be labeled and placed in a sterile temporary container with an icepack. At the end of the day all racks will be transported to the COVID-19 clinical genomics Laboratory at UO, ensuring that they will arrive no longer than 48 hours after collection.