In late 2020, the Center for American Indian and Rural Health Equity (CAIRHE) at Montana State University was awarded a two-year grant from the National Institutes of Health to examine COVID-19 testing strategies among underserved populations in Montana and Washington. The grant is part of the NIH’s $1.4 billion Rapid Acceleration of Diagnostics (RADx) initiative, created in the early weeks of the COVID-19 pandemic to address the need for scaled-up testing across the country. A component targeting underserved populations known as RADx-UP funds community-engaged projects, including CAIRHE’s, that partner with vulnerable communities hardest hit by the pandemic.

Protecting our Community logo

The study, titled Protecting Our Community: A Pragmatic Randomized Trial of Home-based COVID-19 Testing with Native American and Latino Communities, is led by CAIRHE in partnership with the University of Washington’s School of Medicine and Institute of Translational Health Sciences; the Fred Hutchinson Cancer Research Center in Seattle; and Salish Kootenai College and the Confederated Salish and Kootenai Tribes on the Flathead Reservation in Montana. CAIRHE Director Alexandra Adams, M.D., Ph.D., is principal investigator for the study. A local community advisory board is involved in all stages of the research in each study location.

The COVID-19 pandemic has disproportionately affected American Indian (AI) and Latino communities, and these groups also have increased risk of poor prognosis due to high rates of chronic disease such as diabetes, cardiovascular disease, and cancer. In the northwestern United States, AI and Latino communities already face significant disparities in health care access, which have been further exacerbated by the COVID-19 pandemic. This study leverages long-term community-based participatory research partnerships to test the hypothesis that home-based testing will be feasible, impactful, and better-accepted using active delivery of test kits by trusted community health educators in two vulnerable, high-risk rural communities. The study's two long-term partner communities are the Flathead Indian Reservation of the Confederated Salish and Kootenai Tribes in Montana, and the Yakima Valley of Washington, a large Latino community.

The study team will determine the cultural, social, behavioral, and economic barriers to home-based SARS-CoV-2 testing; culturally adapt and enhance home-testing educational materials and create home-testing instructional graphics and YouTube videos; conduct a 2-arm pragmatic randomized trial of active (delivered by community health educator) vs. passive (mailed) home-based testing kits for testing completion; and create model community-driven testing protocols that can have significant impact for increasing home-based testing uptake among AI and Latino communities nationally. This work will enable underserved AI and Latino communities to take full advantage of the coming wave of rapid point-of-care home tests and decrease the significant impact of COVID-19 in their communities.

For questions and press inquiries, please contact James Burroughs, CAIRHE program coordinator, at jburroughs@montana.edu.