F3.01 - IGNITE: Mobilizing Community-driven Public Health: Increasing Diagnostic Testing Access for Underserved Individuals Through Lab-in-a-van Partnerships

Brief Abstract Summary: Discover how community-driven public health paired with an innovative mobile testing model significantly increased access to diagnostic testing for underserved individuals in Connecticut. We will share lessons learned from our mobile lab-in-a-van community testing program and the opportunities this pilot revealed for addressing healthcare inequities. This will include: (1) how community-driven mobile testing programs are a practical strategy for delivering health services, addressing unmet needs and removing access barriers; (2) the importance of establishing relationships with trusted community partners to understand the demands, deficits, and strengths of existing resources as well as accelerate pilot development and increase participation; and (3) how a community testing program must be built with target demographic(s) in mind - aligning with existing resources/health services, building on trust, and offering value to the community.

Detailed abstract description: Our mobile testing implementation, designed to improve access to COVID-19 testing, is a model others can draw from to rapidly provide health services to communities that are under-resourced. With support from a NIH RADxUP grant (RP2 R0604), between June 2023 to July 2024, a mobile testing van was deployed to 123 community events and administered 1,428 free SARS-CoV-2 tests. Samples were processed using SalivaDirect’s extraction-free RT-qPCR protocol on a CLIA licensed van operated by Yale Pathology Labs under FDA Emergency Use Authorization; diagnostic results were available in as little as two hours. Approximately 100 community leaders and organizations with existing relationships with underserved, uninsured, and/or low-income communities in the region were contacted to offer input on pilot design, engagement strategies, and test site selection. Iterative engagement was used to refine outreach strategies, identify events or services to pair testing events with, and better understand barriers and evolving community health needs.

Each participant tested responded to an IRB-approved survey. Information collected confirms that mobile testing is a feasible, accessible, and flexible way to meet the healthcare needs of the community and is a model shown to be highly accepted by the public (74% (597/808) agreed that the mobile testing van was easy to access and 75% (608/808) felt comfortable using the van to get a COVID-19 test; 48% (255/529) were unaware of alternate COVID-19 testing opportunities). This pilot also confirmed that our method of engaging target populations through a community-driven approach can lead to high participation levels in a testing experience that was easy to use and comfortable for participants (participant ages ranged from 0 to 91 years (mean = 43 years); 53% (300/562) identified as BIPOC; 59% (283/481) had an annual household income <$25,000 and 91% (438/481) <$50,000; 31% (251/808) were uninsured; 29% (167/571) reported that testing at the van was their first COVID-19 test). This indicates that community-driven mobile programs should be considered as a practical strategy for future testing needs of underserved populations.

By combining resources from local nonprofits and well-equipped medical or academic institutions with the on-the-ground expertise of community-centered organizations, we can work together to jointly address structural and systemic inequities key to realizing health equity. This pilot showcases how addressing barriers through community-driven public health can make a significant impact. Namely, establishing relationships with trusted community partners, embracing an iterative engagement process, building a testing program with target demographics in mind and ensuring there is value in what is being offered to the community.