This study will research the efficacy and sustainability of a community-social network outreach model that partners infectious disease health providers with community-based organizations to successfully implement (reach, uptake, delivery and sustainment) COVID-19 point of service, rapid-testing among a highly vulnerable and often underserved population, those who use opioids and other substances. Two distinct social network recruitment strategies with demonstrated efficacy identifying hidden populations and increasing uptake of HIV testing will be adapted and compared. Guided by the EPIS framework, social cognitive theory, and Andersen’s model, this study comprises three phases.
This investigation will provide much needed information to improve health outcomes and to identify effective system-level responses to prevent or arrest the spread of COVID-19 among the social networks of those who use opioids and other substances, a highly vulnerable and often overlooked population.
Study Settings: Treatment/Healthcare Settings
PI: Katherine Elkington, Ph.D.
• Phase 1: Adaptation of outreach recruitment strategies, we will work with our project
community advisory board (CAB) to adapt chain-referral and credible messenger
strategies for uptake of COVID-19 testing, to finalize recruitment and on-site testing
protocols, and to train the CAB in the new protocols and in continuous quality
improvement strategies (Aim 1).
• Phase 2: Strategy Efficacy Trial and Implementation Evaluation, we will compare
the two strategies in a cross-over design at two community based organizations (CBOs)
with long standing history of serving hard-to-reach populations in their communities. The
comparison of strategies is not to identify the statistical superiority of one sampling
strategy in providing population estimates over the other, but instead to identify the
ability of each recruitment strategy to reach the target population and increase uptake of
COVID-19 tests. We will examine the impact of each strategy on (i) reach (recruitment of
target population), (ii) COVID-19 testing/repeat testing, and (iii) service delivery (i.e.
quarantine, medical care and contact tracing) among those who test positive for COVID-
19 (exploratory) (Aim 2).
• Phase 3: Sustainment, CBOs will implement the strategy proven efficacious based on
outcomes, and we will examine their sustainment of the program (Aim 2).
Implementation evaluation will identify participant-, staff-, and organizational-level factors
that influence the feasibility, acceptability, and sustainability of each strategy in these
CBOs. (Aim 3).
COVID-19 Testing, RADX-UP Supplement