Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial
Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities. To examine the effectiveness of a culturally tailored...
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| creator | DeGarmo, David S De Anda, Stephanie Cioffi, Camille C Tavalire, Hannah F Searcy, Jacob A Budd, Elizabeth L Hawley McWhirter, Ellen Mauricio, Anne Marie Halvorson, Sven Beck, Emily A Fernandes, Llewellyn Currey, Mark C Ramírez García, Jorge Cresko, William A Leve, Leslie D |
| description | Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities.
To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations.
In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons.
A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust.
The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level.
A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P |
| doi_str_mv | 10.1001/jamanetworkopen.2022.16796 |
| format | Article |
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To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations.
In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons.
A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust.
The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level.
A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P < .001). The intervention was associated with a 0.28 increase in the proportion of Latinx populace being tested compared with control sites for the dependent variable scaled as the proportion of the Latinx populace ×100, or a 0.003 proportion of the raw populace count. The use of a standardized scaling of the proportion of Latinx individuals showed that the relative percentage increase was 0.53 (95% CI, 0.21-0.86) in the intervention sites compared with controls, representing a medium effect size.
To our knowledge, this was the first randomized evaluation of an outreach intervention designed to increase SARS-CoV-2 testing among Latinx populations. Findings could be used to implement strategies to reduce other health disparities experienced by these groups.
ClinicalTrials.gov Identifier: NCT04793464.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2022.16796</identifier><identifier>PMID: 35708690</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Coronaviruses ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; COVID-19 diagnostic tests ; COVID-19 Testing ; Diversity, Equity, and Inclusion ; Female ; Health disparities ; Humans ; Intervention ; Online Only ; Original Investigation ; Pandemics - prevention & control ; Public Health ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2</subject><ispartof>JAMA network open, 2022-06, Vol.5 (6), p.e2216796-e2216796</ispartof><rights>2022. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2022 DeGarmo DS et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-a364t-7c20ad1ee05a648da9dabecc1e39238b323d3cd31cafb5fa1980073c32a09a4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35708690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DeGarmo, David S</creatorcontrib><creatorcontrib>De Anda, Stephanie</creatorcontrib><creatorcontrib>Cioffi, Camille C</creatorcontrib><creatorcontrib>Tavalire, Hannah F</creatorcontrib><creatorcontrib>Searcy, Jacob A</creatorcontrib><creatorcontrib>Budd, Elizabeth L</creatorcontrib><creatorcontrib>Hawley McWhirter, Ellen</creatorcontrib><creatorcontrib>Mauricio, Anne Marie</creatorcontrib><creatorcontrib>Halvorson, Sven</creatorcontrib><creatorcontrib>Beck, Emily A</creatorcontrib><creatorcontrib>Fernandes, Llewellyn</creatorcontrib><creatorcontrib>Currey, Mark C</creatorcontrib><creatorcontrib>Ramírez García, Jorge</creatorcontrib><creatorcontrib>Cresko, William A</creatorcontrib><creatorcontrib>Leve, Leslie D</creatorcontrib><title>Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities.
To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations.
In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons.
A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust.
The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level.
A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P < .001). The intervention was associated with a 0.28 increase in the proportion of Latinx populace being tested compared with control sites for the dependent variable scaled as the proportion of the Latinx populace ×100, or a 0.003 proportion of the raw populace count. The use of a standardized scaling of the proportion of Latinx individuals showed that the relative percentage increase was 0.53 (95% CI, 0.21-0.86) in the intervention sites compared with controls, representing a medium effect size.
To our knowledge, this was the first randomized evaluation of an outreach intervention designed to increase SARS-CoV-2 testing among Latinx populations. Findings could be used to implement strategies to reduce other health disparities experienced by these groups.
ClinicalTrials.gov Identifier: NCT04793464.</description><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 diagnostic tests</subject><subject>COVID-19 Testing</subject><subject>Diversity, Equity, and Inclusion</subject><subject>Female</subject><subject>Health disparities</subject><subject>Humans</subject><subject>Intervention</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Pandemics - prevention & control</subject><subject>Public Health</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkU1v1DAQhiMEolXpX0AWXLhkO7bjOO4BqQoFVlppJbRwtWYdp_WS2IudlJZfj0s_VHrySH7m1cw8RfGOwoIC0JMdjujt9DvEn2Fv_YIBYwtaS1W_KA6ZkFXJGxAvn9QHxXFKOwBgQLmqxevigAsJTa3gsBjO-96ayV1Zb1MioSdI2vWP5aeSKrKxaXL-gqznKVo0l2TpJxszOrngSR8iWWEGrkkbxnH2bnI2nZIz0g5zyiD5hr4Lo_tjO7KJDoc3xaseh2SP79-j4vvn8037tVytvyzbs1WJvK6mUhoG2FFrQWBdNR2qDrfWGGq5YrzZcsY7bjpODfZb0SNVDYDkhjMEhVXPj4qPd7n7eTvazuSBIw56H92I8UYHdPr_H-8u9UW40opBJQTkgA_3ATH8mvMV9OiSscOQTx_mpFktpZBcCprR98_QXZijz-tpJnndyIorlanTO8rEkFK0_eMwFPStV_3Mq771qv95zc1vn67z2Ppgkf8FF9-leg</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>DeGarmo, David S</creator><creator>De Anda, Stephanie</creator><creator>Cioffi, Camille C</creator><creator>Tavalire, Hannah F</creator><creator>Searcy, Jacob A</creator><creator>Budd, Elizabeth L</creator><creator>Hawley McWhirter, Ellen</creator><creator>Mauricio, Anne Marie</creator><creator>Halvorson, Sven</creator><creator>Beck, Emily A</creator><creator>Fernandes, Llewellyn</creator><creator>Currey, Mark C</creator><creator>Ramírez García, Jorge</creator><creator>Cresko, William A</creator><creator>Leve, Leslie D</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220601</creationdate><title>Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial</title><author>DeGarmo, David S ; De Anda, Stephanie ; Cioffi, Camille C ; Tavalire, Hannah F ; Searcy, Jacob A ; Budd, Elizabeth L ; Hawley McWhirter, Ellen ; Mauricio, Anne Marie ; Halvorson, Sven ; Beck, Emily A ; Fernandes, Llewellyn ; Currey, Mark C ; Ramírez García, Jorge ; Cresko, William A ; Leve, Leslie D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a364t-7c20ad1ee05a648da9dabecc1e39238b323d3cd31cafb5fa1980073c32a09a4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - prevention & control</topic><topic>COVID-19 diagnostic tests</topic><topic>COVID-19 Testing</topic><topic>Diversity, Equity, and Inclusion</topic><topic>Female</topic><topic>Health disparities</topic><topic>Humans</topic><topic>Intervention</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Pandemics - prevention & control</topic><topic>Public Health</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DeGarmo, David S</creatorcontrib><creatorcontrib>De Anda, Stephanie</creatorcontrib><creatorcontrib>Cioffi, Camille C</creatorcontrib><creatorcontrib>Tavalire, Hannah F</creatorcontrib><creatorcontrib>Searcy, Jacob A</creatorcontrib><creatorcontrib>Budd, Elizabeth L</creatorcontrib><creatorcontrib>Hawley McWhirter, Ellen</creatorcontrib><creatorcontrib>Mauricio, Anne Marie</creatorcontrib><creatorcontrib>Halvorson, Sven</creatorcontrib><creatorcontrib>Beck, Emily A</creatorcontrib><creatorcontrib>Fernandes, Llewellyn</creatorcontrib><creatorcontrib>Currey, Mark C</creatorcontrib><creatorcontrib>Ramírez García, Jorge</creatorcontrib><creatorcontrib>Cresko, William A</creatorcontrib><creatorcontrib>Leve, Leslie D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DeGarmo, David S</au><au>De Anda, Stephanie</au><au>Cioffi, Camille C</au><au>Tavalire, Hannah F</au><au>Searcy, Jacob A</au><au>Budd, Elizabeth L</au><au>Hawley McWhirter, Ellen</au><au>Mauricio, Anne Marie</au><au>Halvorson, Sven</au><au>Beck, Emily A</au><au>Fernandes, Llewellyn</au><au>Currey, Mark C</au><au>Ramírez García, Jorge</au><au>Cresko, William A</au><au>Leve, Leslie D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>5</volume><issue>6</issue><spage>e2216796</spage><epage>e2216796</epage><pages>e2216796-e2216796</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Latinx individuals have been disproportionately affected during the COVID-19 pandemic caused by the spread of SARS-CoV-2. It is imperative to evaluate newly developed preventive interventions to assess their effect on COVID-19 health disparities.
To examine the effectiveness of a culturally tailored outreach intervention designed to increase SARS-CoV-2 testing rates among Latinx populations.
In this cluster randomized trial performed from February 1 to August 31, 2021, in community settings in 9 Oregon counties, 38 sites were randomized a priori (19 to the community health promoters intervention and 19 to outreach as usual wait-listed controls). Thirty-three sites were activated. A total of 394 SARS-CoV-2 testing events were held and 1851 diagnostic samples collected, of which 919 were from Latinx persons.
A culturally informed outreach program was developed that made use of promotores de salud (community health promoters) to increase Latinx SARS-CoV-2 testing. Strategies addressed barriers by disseminating information on testing events in English and Spanish, mitigating misinformation, and increasing trust.
The primary outcomes were the count of sample tests from Latinx persons and the sampled proportion of the Latinx populace. Site-level covariates included census tract Latinx populace, nativity (number of US-born individuals per 100 population), median age, and income inequality. Time-varying covariates included number of new weekly SARS-CoV-2-positive cases and percentage of vaccine coverage at the county level.
A total of 15 clusters (sites) were randomized to the control group and 18 to the community health promoters group. A total of 1851 test samples were collected, of which 995 (53.8%) were from female participants and 919 (49.6%) were from Latinx individuals. The intervention tested 3.84 (95% CI, 2.47-5.97) times more Latinx individuals per event than controls (incident rate ratio, 0.79; 95% CI, 0.46-1.34; Cohen d = 0.74; P < .001). The intervention was associated with a 0.28 increase in the proportion of Latinx populace being tested compared with control sites for the dependent variable scaled as the proportion of the Latinx populace ×100, or a 0.003 proportion of the raw populace count. The use of a standardized scaling of the proportion of Latinx individuals showed that the relative percentage increase was 0.53 (95% CI, 0.21-0.86) in the intervention sites compared with controls, representing a medium effect size.
To our knowledge, this was the first randomized evaluation of an outreach intervention designed to increase SARS-CoV-2 testing among Latinx populations. Findings could be used to implement strategies to reduce other health disparities experienced by these groups.
ClinicalTrials.gov Identifier: NCT04793464.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>35708690</pmid><doi>10.1001/jamanetworkopen.2022.16796</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - prevention & control COVID-19 diagnostic tests COVID-19 Testing Diversity, Equity, and Inclusion Female Health disparities Humans Intervention Online Only Original Investigation Pandemics - prevention & control Public Health SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 |
| title | Effectiveness of a COVID-19 Testing Outreach Intervention for Latinx Communities: A Cluster Randomized Trial |
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