Exploring barriers and facilitators of implementing an at-home SARS-CoV-2 antigen self-testing intervention: The Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiatives

Lisa Maria Cross, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Amelia DeFosset, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Bola Yusuf, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Donaldson Conserve, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, D.C, United States of America.
Rakiah Anderson, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Christina Carilli, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Warren Kibbe, Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America.
Michael Cohen-Wolkowiez, Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America.
Alan Richmond, Community-Campus Partnerships for Health, Raleigh, North Carolina, United States of America.
Giselle Corbie, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Gaurav Dave, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

PloS one

Volume

18

Issue

11

DOI

10.1371/journal.pone.0294458

Abstract

BACKGROUND: Evaluating community-based programs provides value to researchers, funding entities, and community stakeholders involved in program implementation, and can increase program impact and sustainability. To understand factors related to program implementation, we aimed to capture the perspective of community partners engaged in organizing and executing community-engaged programs to distribute COVID-19 at-home tests in underserved communities. METHODS: We conducted semi-structured interviews and focus groups with community-based stakeholders informed by the Outcomes for Implementation Research framework. RESULTS: Findings describe how community-engaged communication and dissemination strategies drove program adoption among grassroots stakeholders. Establishing and sustaining trusted relationships was vital to engaging partners with aligned values and capacity. Respondents characterized the programs as generally feasible and appropriate, and community partners felt capable of delivering the program successfully. However, they also described an increased burden on their workforce and desired more significant support. Respondents recognized the programs' community engagement practices as a critical facilitator of acceptability and impact. DISCUSSION: Implementation evaluation aims to inform current and future community outreach and engagement efforts with best practices. As we continue to inform and advance community-engaged disaster response practice, a parallel reimagining of public health funding mechanisms and timelines could provide a foundation for trust, collaboration, and community resiliency that endures beyond a given crisis.

Department

Prevention and Community Health

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