Reaching Structurally Vulnerable Populations Using Low-Barrier COVID-19 Testing Clinics Co-Created with...

Area of Science:

• Public Health
• Health Equity
• Community-Based Research

Background:

• The COVID-19 pandemic highlighted health disparities, disproportionately impacting structurally vulnerable communities.
• A critical need existed to enhance COVID-19 testing accessibility within these underserved populations to curb viral transmission and facilitate treatment access.

Purpose of the Study:

• To evaluate the effectiveness of a partnership between an academic medical center and community-based organizations (CBOs) in reaching structurally vulnerable populations.
• To assess whether co-created, low-barrier COVID-19 walk-up testing clinics successfully served target demographics in Portland, Maine.

Main Methods:

• COVID-19 rapid antigen testing was offered three times weekly at CBO sites from January 2022 to May 2023.
• A brief survey on testing reasons was administered, followed by a demographic and perception survey after self-swabbing.
• Outreach specifically targeted unhoused individuals, immigrants, and those with low income and/or lacking insurance.

Main Results:

• Out of 246 completed tests, 7% were positive for COVID-19.
• Participants tested primarily due to symptoms (60%), close contact (29%), or to access services (33%).
• The clinics successfully reached vulnerable groups: 39% unhoused, 22% non-English speakers, 23% uninsured, and 46% earning under $20,000.

Conclusions:

• Collaborative, low-barrier walk-up testing clinics in partnership with trusted CBOs are effective in reaching structurally vulnerable populations.
• This model facilitated access to COVID-19 testing for hard-to-reach community members.
• Building trust through CBO collaboration was key to engaging target populations.