Mobilizing Community-Driven Public Health: Increasing Access to Diagnostic Testing for Underserved Individuals...

Underrepresented populations, who often have the highest need for accessible health care, frequently face barriers to accessing services. To address health inequities, researchers evaluated a community-informed lab-in-a-van model that was designed to increase access to COVID-19 testing for vulnerable populations.

Free saliva-based SARS-CoV-2 diagnostic testing was offered between June 2023 and July 2024 at 123 events in Connecticut, U.S., using a Clinical Laboratory Improvement Amendments-certified mobile laboratory. Approximately 100 local leaders and organizations informed the program's design. After providing samples, participants completed an IRB-approved survey; responses were stored using REDCap.

Offering on-site testing helped remove barriers and increased access for traditionally underserved communities. Overall, 1,428 individuals were tested, and 838 completed a testing experience survey. Of the respondents, 54% identified as Black, Indigenous, People of Color; 59% reported an annual household income <$25,000; and 31% were uninsured. Participants reported that the service was easy to access (74%) and comfortable to use (75%); 29% received their first COVID-19 test, and 48% were unaware of alternative testing options. Results were reported in an average of 3.1 hours, enabling many participants to receive their diagnostic results during the community event; 48 positive samples were identified.

This program evaluation demonstrates that community-informed mobile testing programs capable of delivering same-day diagnostic results can expand access to testing among underserved populations and may represent a scalable strategy for improving diagnostic access during future public health emergencies.