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. 2022 Jul:118:106783.
doi: 10.1016/j.cct.2022.106783. Epub 2022 May 6.

Implementing expanded COVID-19 testing in Massachusetts community health centers through community partnerships: Protocol for an interrupted time series and stepped wedge study design

Gina R Kruse  1 , Leslie Pelton-Cairns  2 , Elsie M Taveras  3 , Susan Dargon-Hart  2 , Daniel A Gundersen  4 , Rebekka M Lee  5 , Barbara E Bierer  6 , Erica Lawlor  7 , Regina C LaRocque  8 , Julia L Marcus  9 , Madeline E Davies  10 , Karen M Emmons  5 ; RADx-MA Partnership
Affiliations

Implementing expanded COVID-19 testing in Massachusetts community health centers through community partnerships: Protocol for an interrupted time series and stepped wedge study design

Gina R Kruse et al. Contemp Clin Trials. 2022 Jul.

Abstract

Background: Community Health Centers (CHCs) are a critical source of care for low-income and non-privately insured populations. During the pandemic, CHCs have leveraged their infrastructure and role as a trusted source of care to engage the communities they serve in COVID-19 testing.

Methods: To directly address the impact that COVID-19 has had on historically marginalized populations in Massachusetts, we designed a study of community-engaged COVID-19 testing expansion: (1) leveraging existing partnerships to accelerate COVID-19 testing and rapidly disseminate effective implementation strategies; (2) incorporating efforts to address key barriers to testing participation in communities at increased risk for COVID-19; (3) further developing partnerships between communities and CHCs to address testing access and disparities; (4) grounding the study in the development of a shared ethical framework for advancing equity in situations of scarcity; and (5) developing mechanisms for communication and science translation to support community outreach. We use a controlled interrupted time series design, comparing number of COVID-19 tests overall and among people identified as members of high-risk groups served by intervention CHCs compared with six matched control CHCs in Massachusetts, followed by a stepped wedge design to pilot test strategies for tailored outreach by CHCs.

Conclusions: Here, we describe a community-partnered strategy to accelerate COVID-19 testing in historically marginalized populations that provides ongoing resources to CHCs for addressing testing needs in their communities. The study aligns with principles of community-engaged research including shared leadership, adequate resources for community partners, and the flexibility to respond to changing needs over time.

Keywords: COVID-19 testing; Community health centers; Community-engaged research; Health equity; Implementation science.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Health Equity Informed Implementation Factors* (Consolidated Framework for Implementation Research). *Italicized bullets indicate health equity factors and outcomes added.
Fig. 2
Fig. 2
Organizational structure of the study team.
See this image and copyright information in PMC

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