Indications of digital literacy during Latino-focused, community-based COVID-19 testing implementation

Abstract

Objective: We sought to characterize indicators of digital literacy among persons testing for COVID-19 and community health workers (CHWs) providing testing via a digital platform in low-income, majority-Latino communities in California.

Materials and methods: From March 2021 to March 2022, we trained CHWs to provide community-based COVID-19 testing that relied on a digital platform for registration, recording and reporting of results. Among community members, we examined factors associated with accessing test results digitally and time to results receipt. Among CHWs, we evaluated factors associated with self-reported difficulty using the digital platform and improvement post-training.

Results: Overall, 5044 community members were tested for COVID-19. Accessing results digitally vs non-digitally was associated with younger age (Odds Ratio [OR]: 1.02 [95% Confidence Interval [CI], 1.01-1.03], for each year decrease), rural residence (OR:1.61 [95% CI, 1.30-1.99]), and providing an email address at registration (OR: 2.18 [95% CI, 1.80-2.65]). The likelihood of providing an email address at registration was increased among younger, non-Latino, English-speaking, female, and rural testers. Among persons accessing results digitally, median time from testing to result receipt was 41 min, with increased time associated with rural residence and older age. Among 42 CHWs surveyed, 29 (68%) reported technology-related challenges when providing testing: those reporting challenges were more likely to be older and rural CHWs. Rural CHWs were less likely to report technical skill improvement post-training.

Discussion: Email provision may be an indicator of digital literacy among persons testing for COVID-19 in low-income, majority-Latino communities. Rural and older CHWs may need more intensive digital training.

Conclusion: Efforts to improve digital literacy in underserved communities are likely needed to realize the full potential of community-based health interventions that utilize digital platforms.

Keywords: COVID-19; community health worker; digital literacy; informatics.

Figure 1.

Study design with identified indicators (dependent variables), demographics of interest (independent variables), and methods of analysis.