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Addressing Covid-19 Testing Inequities Among Underserved Populations in Massachusetts

A Rapid Qualitative Exploration of Health Center Staff, Partner, and Resident Perceptions

Bibliographic Data

ID22090959
AuthorsRebekka M Lee (0000-0002-5863-7907, Harvard University, corresponding author), Veronica L Handunge (Harvard University), Samantha L Augenbraun (Harvard University), Huy Nguyên (0000-0003-4897-1888), Huy Tien Nguyen (0000-0002-9948-1048), Cristina Huebner Torres (0000-0002-4773-6010), Alyssa Ruiz (Lynn University), Karen M Emmons (0000-0002-0685-6446, Harvard University), for the RADx-MA Research Partnership
Year2022
Volume10
Pages838544-838544
Publication date2022-03-24
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.838544
PMID35400042
OpenAlexW4220978456
LanguageEN
Citations received5
References cited28

Introduction: Access to COVID-19 testing has been inequitable and misaligned with community need. However, community health centers have played a critical role in addressing the COVID-19 testing needs of historically disadvantaged communities. The aim of this paper is to explore the perceptions of COVID-19 testing barriers in six Massachusetts communities that are predominantly low income and describe how these findings were used to build tailored clinical-community strategies to addressing testing inequities. Methods: Between November 2020 and February 2021, we conducted 84 semi-structured qualitative interviews with 107 community health center staff, community partners, and residents. Resident interviews were conducted in English, Spanish, Vietnamese, and Arabic. We used a 2-phase framework analysis to analyze the data, including deductive coding to facilitate rapid analysis for action and an in-depth thematic analysis applying the Social Ecological Model. Results: Through the rapid needs assessment, we developed cross-site suggestions to improve testing implementation and communications, as well as community-specific recommendations (e.g., locations for mobile testing sites and local communication channels). Upstream barriers identified in the thematic analysis included accessibility of state-run testing sites, weak social safety nets, and lack of testing supplies and staffing that contributed to long wait times. These factors hindered residents' abilities to get tested, which was further exacerbated by individual fears surrounding the testing process and limited knowledge on testing availability. Discussion: Our rapid, qualitative approach created the foundation for implementing strategies that reached underserved populations at the peak of the COVID-19 pandemic in winter 2021. We explored perceptions of testing barriers and created actionable summaries within 1-2 months of data collection. Partnering community health centers in Massachusetts were able to use these data to respond to the local needs of each community. This study underscores the substantial impact of upstream, structural disparities on the individual experience of COVID-19 and demonstrates the utility of shifting from a typical years' long research translation process to a rapid approach of using data for action

2019-20 coronavirus outbreak · Disease · Family medicine · Health equity · Medical education · Perception · Public health · Qualitative research · Sociology · COVID-19 epidemiological studies · Medicine · Nursing · Psychology · SARS-CoV-2 detection and testing · Viral Infections and Outbreaks Research · Gerontology · Virology

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Citations per year1.67
Citation span2023 - 2025 (3)
Highly citedNo
Open DOIOpen Access
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