Session: Addressing Disparities in Access to COVID-19 Testing Via Community Health Workers Led Culturally Grounded Intervention in Southwest (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

Background: Disparities in accessing COVID-19 testing is a new societal concern in Southwest region and across the United States of America (US). These disparities are partially explained by non-medical factors or social determinants of health (SDoH). The barriers to COVID-19 testing are multifaceted, necessitating unprecedented efforts to bring together entities which rarely collaborated with each other before the pandemic. The Southwest region experienced significant disparities in access to COVID-19 testing, and a cross-sectoral collaboration comprised of a local university, community health organizations, and community leaders was formed with funding from National Institutes of Health (NIH). This team developed the R.A.P.I.D. model, which engages the expertise of community health workers' (CHWs) to address SDoH that contribute to disparities in accessing COVID-19 testing that disproportionately affect racial/ethnic minorities.

Data source: A transdisciplinary team gathered data via multi-pronged approaches including focus groups, longitudinal surveys, and publicly available epidemiological and socioeconomic data of Zip Code Tabulation Areas (ZCTAs) of Arizona. The team qualified to apply and later attained supplemental funding to an existing award (NIMHD/NIH: U54MD002316-14, Marsiglia, PI). The supplemental funding supported the expansion of the team and the development, implementation, and evaluation the effectiveness of the R.A.P.I.D. model. The project is implementing a culturally grounded intervention across Arizona, which was designated a Priority Community for Testing (PCT). CHWs with strong and long-lasting community embeddedness implemented the intervention and effectively reached out and engaged vulnerable and underserved residents.

Four Oral Presentations Study 1 introduces the R.A.P.I.D. model and describes how the most vulnerable/ underserved communities and the most impactful social determinants of health (SDoHs) were identified. Study 2 documents the experiences and narratives of CHWs who implemented the R.A.P.I.D. model in the field. They provide an account of the role of the CHWs and their perspectives on how to better prepare communities for future health crises. Study 3 presents results of an analysis of ZCTA epidemiological data from the entire state of Arizona and highlights Latinx communities that were disproportionally affected by the pandemic in its early stages. The findings also document a quick recovery in the same communities in terms of case counts between October 2020 and November 2021. Study 4 compares participants in the R.A.P.I.D. project with a matched control group comprised of individuals tested at a state-run COVID-19 testing program that lacked cultural grounding. The study examines SDoH (e.g., educational attainment, health coverage) and COVID-19 mitigating behaviors, mask wearing, and economic challenges during pandemics.

Expected Impact: This symposium will provide a unique opportunity to review a wealth of empirical data gathered as part of an intervention research designed to address disparities in access to COVID-19 testing. Culturally participatory research will be highlighted through the perspectives of CHWs who also engaged in the R.A.P.I.D. model. Attendees will get knowledge on community-based strategies on how to address the inequities associated with the ongoing COVID-19 pandemic. Participants will also learn about the role social work can play as convener and leader of an innovative transdisciplinary research team addressing a pressing public health crisis.