Throughout the Coronavirus disease (COVID-19) pandemic, rates of COVID-19 have beenpersistently high in San Diego County's central and southern communities near the UnitedStates/Mexico border. These regions predominantly house Latino residents, the ethnicminority community most impacted by COVID-19 in San Diego. In the Phase I project,University of California, San Diego (UCSD) partnered with San Ysidro Health (SYH) and theGlobal Action Research Center, to co-create and demonstrate the impact of a COVID-19testing program in San Ysidro, one of the most impacted areas from COVID-19 in San DiegoCounty. To date, the project tested >10,000 community members (92% Latino) and receivedrequests to scale-out the testing program to additional primary care clinic sites.In this Phase III project, Community-engaged Optimization of COVID-19 Rapid EvaluationAnd TEsting Experiences (CO-CREATE-Ex) will extend work with the Phase I community andclinical partners to refine, specify, implement, and evaluate an implementation strategybundle that optimizes COVID-19 testing, expanding beyond current polymerase chainreaction (PCR) testing to FDA-authorized COVID-19 rapid antigen testing.
CO-CREATE-Ex will roll-out our implementation using 3 strategies:
1. keeping the current, walk-up free testing protocol
2. Offering Community Health Worker (CHW) to lead COVID-19 test counseling, preventive
care reminders, and offer testing support
3. Installing vending machines that will dispense FDA-authorized self-testing kits.
For each strategy, participants will consent into study, provide demographics and test
history, and receive a free rapid antigen test (RAT) kit. After receiving the test kit,
participants will be prompted to return their results and fill out a survey about their
COVID-19 experiences. Study subjects will be contacted up to three times over a course of
4 weeks to return their results and complete the survey. Study coordinators will use
participants' preferred method of contact.
Behavioral: COVID-19 walk-up, on-site testing strategy
This strategy is a no-appointment, walk-up point-of-care PCR and rapid testing strategy
for clinic patients and community members. It will be offered 5 days/week for 7 hours
during the first 3 months of the trial at Clinic 1. The intensity will decrease over the
trial ending with 1 SYH Medical Assistant overseeing the testing protocol. Bilingual
research staff will be trained to oversee onsite testing.
Behavioral: Community Health Worker (CHW) leading testing navigation and general preventive care reminders
This strategy provides health counseling about when COVID-19 testing is recommended,
which test to use, testing instructions, and how to interpret results. Community Health
Workers (CHW) will also offer general preventive health care reminders such as flu shots,
blood pressure checks, and A1c screenings. This strategy will be available full-time
during the first 3 months of roll-out at each clinic and after 3 months, the CHW will be
available as needed. Trained bilingual CHW will be supervised by a SYH employee.
Behavioral: No-cost self-testing kit vending machines
This strategy includes vending machines that will provide interactive instructions for
accessing free self-testing COVID-19 kits located outside of clinics for patients and
community members to use anytime. The vending machines will be available 24 hours/day, 7
days a week.
Inclusion Criteria:
- Speak English and/or Spanish
- Affiliated with San Ysidro Health as a patient at select clinics (San Ysidro, Chula
Vista, Lincoln Park, and Logan Heights) OR
- A member of a community near a San Ysidro Health clinic (San Ysidro, Chula Vista,
Lincoln Park, and Logan Heights).
Exclusion Criteria:
- Institutionalization for psychiatric disorder, developmental delay, or criminal
activity.
- Unable to provide informed consent.
San Ysidro Health Centers
San Ysidro, California, United States
Investigator: Breanna Reyes, MPH
Breanna Reyes, MPH
858-945-4553
cocreate@health.ucsd.edu
CO-CREATE-EX Project
858-945-4554
cocreate@health.ucsd.edu
Louise Laurent, MD/PhD, Principal Investigator
University of California, San Diego