A Nurse-Community Health Worker-Family Partnership Model: Addressing Uptake of COVID-19 Testing and Control Measures
A Nurse-Community Health Worker-Family Partnership Model: Addressing Uptake of COVID-19 Testing and Control Measures
Historically, health disparities in the US are concentrated among underserved communities and
 socially vulnerable populations. The disproportionate COVID-19 related morbidity and
 mortality in communities of color and socioeconomic disadvantage acutely highlight this
 persistent public health problem, drawing attention to the urgent need for more equitable
 reach of testing, prevention, and control measures. The proposed research addresses this need
 using a 2-arm randomized controlled trial (RCT) that will evaluate the effectiveness of the
 Nurse-Community Health Worker (CHW)-Family Partnership intervention in promoting COVID-19
 testing uptake, adoption of COVID control measures, and mutual aid capacity at the household
 level in an underserved and vulnerable population disproportionately affected by COVID-19.
 Enrolled households will be randomly assigned to either the intervention group where families
 will receive the Nurse-CHW-Family Partnership intervention including the offer of in-home
 testing and referral to seasonal influenza vaccination services, or the treatment-as-usual
 control group, which will be used to measure actual testing rates among public housing
 residents in relation to participant and household characteristics. The study hypothesis is
 that the Nurse-CHW-Family Partnership intervention will improve household-level COVID-19
 testing uptake, adoption of COVID control measures, and mutual aid capacity relative to the
 treatment-as-usual control.
The investigators will recruit and follow a randomly-chosen sample of NYCHA public housing
 residents in the proposed target community who meet multiple criteria for being considered
 vulnerable or underserved. The current study will address knowledge gaps regarding COVID-19
 testing, treatment, and household prevention strategies, and generate new knowledge related
 to the epidemiology of COVID-19 in these communities. Working with community partners, the
 investigators will create an acceptable and feasible intervention and testing infrastructure
 in advance of the influenza season, with a view toward designing best practices for
 sustainable COVID-19 testing, prevention, and preparedness for vaccination trials. The
 investigators will implement a 2-arm RCT that will evaluate the effectiveness of the
 Nurse-CHW-Family Partnership Intervention in promoting COVID testing uptake, adoption of
 COVID control measures, and household mutual aid capacity. The investigators will recruit
 members of randomly selected households in their homes using area sampling methods used with
 excellent results in the investigators' previous research in the target community.
 Participants will complete a baseline assessment and the entire household will be randomized
 to either the experimental or a treatment-as-usual control condition, which will be used to
 measure actual testing rates among public housing residents in relation to participant and
 household characteristics. The baseline sample will include 270 households, and 810
 individual household members, randomized in a 2:1 ratio, intervention:control. Families will
 complete follow-up assessments at 6 and 9 months following the baseline. In-home testing and
 referral to seasonal influenza vaccination services will be offered to the intervention
 group; whereas the control group will receive treatment as usual at multiple NYC Department
 of Health COVID-19 testing sites that are within walking distance of each of the three
 housing complexes. Test acceptance will be recorded, and incentives will be paid for study
 visits, not for testing.
Inclusion Criteria:

 -  Residence in one of the public housing complexes in Mott Haven, South Bronx

 -  English or Spanish-speaking

 -  Age 10 years or older

 -  Willing and able to provide informed consent or assent

 Exclusion Criteria:

 -  Non-resident of one of the public housing complexes in Mott Haven, South Bronx

 -  Neither English nor Spanish speaker

 -  Younger than 10 years old, unless household index case tests antigen positive. In this
 instance, all members of family will be included.

 -  Unwilling or unable to provide informed consent or assent