COVID-19 diagnostic testing among underserved Latino communities: Barriers and facilitators

In the U.S., Latinos are disproportionately affected by the COVID-19 pandemic. A critical step to reduce the spread of COVID-19 is diagnostic testing. Yet, for testing to be effective, barriers must be reduced or eliminated and facilitators promoted. Guided by principles of community-based participatory research, we collected data from 64 community health workers and Promotor/as (CHW/Ps) in Texas to identify relevant personal, community-level, and testing-related barriers and facilitators to diagnostic testing for COVID-19 among underserved Latino communities. Data were collected through an online survey and focus groups. A large majority of CHW/Ps (90.6%) reported that they perceived diagnostic testing to be important for their communities; however, only 42.2% believed that their communities understand the use of testing. Personal barriers to diagnostic testing included mistrust and fear, including fear of: becoming infected and infecting others, job/income loss, discrimination/stigmatisation, uncovering other diseases, and mishandling of personal information. Community-level barriers to testing included fear-inducing myths and beliefs. Test-related factors included cost and accuracy of testing, testing procedures, inadequate and insufficient information, and logistics pertaining to testing sites. Facilitators to testing included building trust between communities and those administering testing, along with receiving culturally and contextually appropriate testing information. Diagnostic testing for COVID-19 among underserved Latino communities is complex and suboptimal. Targeted efforts are needed to overcome personal, community and test-related barriers in a culturally and contextually sensitive manner in order to prevent harm and to reduce further risk among underserved communities.