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151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study
OBJECTIVES/GOALS: To test the effect of a trusted Community Health Worker (CHW) support model to increase accessibility, feasibility and completion of COVID-19 home-testing in Native American and Latino communities. METHODS/STUDY POPULATION: We conducted a multi-site pragmatic randomized controlled...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129695/ http://dx.doi.org/10.1017/cts.2023.232 |
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author | Webber, Eliza Gregor, Charlie Hassell, Laurie Thompson, Matthew Drain, Paul Ko, Linda Dupuis, Virgil Garza, Lorenzo Lambert, Allison Bishop, Sonia Warne, Teresa Adams, Alexandra |
author_facet | Webber, Eliza Gregor, Charlie Hassell, Laurie Thompson, Matthew Drain, Paul Ko, Linda Dupuis, Virgil Garza, Lorenzo Lambert, Allison Bishop, Sonia Warne, Teresa Adams, Alexandra |
author_sort | Webber, Eliza |
collection | PubMed |
description | OBJECTIVES/GOALS: To test the effect of a trusted Community Health Worker (CHW) support model to increase accessibility, feasibility and completion of COVID-19 home-testing in Native American and Latino communities. METHODS/STUDY POPULATION: We conducted a multi-site pragmatic randomized controlled trial among adult Native Americans and Latinos from the Flathead reservation in Montana and Yakima Valley in Washington. Participants were block randomized by site location and age to either an active or passive study arm. Participants in the active arm received assistance with online COVID-19 test kit registration and virtual swabbing support from CHWs, while the passive study arm received the standard-of-care support from the COVID-19 home testing kit vendor. Simple and multivariate logistic regression modeled the association between home-testing distribution mechanism and test completion. Multivariate models included community and sex as covariates. Descriptive feedback was collected in a post-test survey. RESULTS/ANTICIPATED RESULTS: Overall, 63% of the 268 enrolled participants completed COVID-19 tests, and 50% completed tests yielding a valid result. Active arm participants had significantly higher odds of test completion (OR 1.66, 95% CI: [1.01, 2.75], p-value=0.04). Differences were most pronounced among adults ≥60 years, with 84% completing testing kits in the active arm, compared to 58% in the passive arm (p=0.07). Ease of use and not having to leave home were top positive aspects of the home-based test while transporting and mailing samples to lab and long/overwhelming instructions were cited as negative aspects. Most test completers (93%) were satisfied with their experience and 95% found CHW assistance useful. Sample expiration and insufficient identifiers were top causes of non-valid test results. DISCUSSION/SIGNIFICANCE: While test completion rates were low in both study arms, the CHW support led to a higher COVID-19 test completion rate, particularly among older adults. Still, CHW support alone does not fully eliminate testing barriers. Socio-economic differences must be accounted for in future product development for home-based testing to improve health equity. |
format | Online Article Text |
id | pubmed-10129695 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-101296952023-04-26 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study Webber, Eliza Gregor, Charlie Hassell, Laurie Thompson, Matthew Drain, Paul Ko, Linda Dupuis, Virgil Garza, Lorenzo Lambert, Allison Bishop, Sonia Warne, Teresa Adams, Alexandra J Clin Transl Sci Health Equity and Community Engagement OBJECTIVES/GOALS: To test the effect of a trusted Community Health Worker (CHW) support model to increase accessibility, feasibility and completion of COVID-19 home-testing in Native American and Latino communities. METHODS/STUDY POPULATION: We conducted a multi-site pragmatic randomized controlled trial among adult Native Americans and Latinos from the Flathead reservation in Montana and Yakima Valley in Washington. Participants were block randomized by site location and age to either an active or passive study arm. Participants in the active arm received assistance with online COVID-19 test kit registration and virtual swabbing support from CHWs, while the passive study arm received the standard-of-care support from the COVID-19 home testing kit vendor. Simple and multivariate logistic regression modeled the association between home-testing distribution mechanism and test completion. Multivariate models included community and sex as covariates. Descriptive feedback was collected in a post-test survey. RESULTS/ANTICIPATED RESULTS: Overall, 63% of the 268 enrolled participants completed COVID-19 tests, and 50% completed tests yielding a valid result. Active arm participants had significantly higher odds of test completion (OR 1.66, 95% CI: [1.01, 2.75], p-value=0.04). Differences were most pronounced among adults ≥60 years, with 84% completing testing kits in the active arm, compared to 58% in the passive arm (p=0.07). Ease of use and not having to leave home were top positive aspects of the home-based test while transporting and mailing samples to lab and long/overwhelming instructions were cited as negative aspects. Most test completers (93%) were satisfied with their experience and 95% found CHW assistance useful. Sample expiration and insufficient identifiers were top causes of non-valid test results. DISCUSSION/SIGNIFICANCE: While test completion rates were low in both study arms, the CHW support led to a higher COVID-19 test completion rate, particularly among older adults. Still, CHW support alone does not fully eliminate testing barriers. Socio-economic differences must be accounted for in future product development for home-based testing to improve health equity. Cambridge University Press 2023-04-24 /pmc/articles/PMC10129695/ http://dx.doi.org/10.1017/cts.2023.232 Text en © The Association for Clinical and Translational Science 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work. |
spellingShingle | Health Equity and Community Engagement Webber, Eliza Gregor, Charlie Hassell, Laurie Thompson, Matthew Drain, Paul Ko, Linda Dupuis, Virgil Garza, Lorenzo Lambert, Allison Bishop, Sonia Warne, Teresa Adams, Alexandra 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title | 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title_full | 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title_fullStr | 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title_full_unstemmed | 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title_short | 151 A Pragmatic Randomized Trial of Home-based testing for COVID-19 in Rural Native American and Latino Communities: Primary results of the Protecting Our Communities Study |
title_sort | 151 a pragmatic randomized trial of home-based testing for covid-19 in rural native american and latino communities: primary results of the protecting our communities study |
topic | Health Equity and Community Engagement |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129695/ http://dx.doi.org/10.1017/cts.2023.232 |
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