Summary of the Funded Parent Award Project EVIDENCE (pErception of coVID tEsting aNd vaccine) was funded through the Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing among Underserved and/or Vulnerable Populations initiative. Project EVIDENCE leverages the infrastructure of a NIMHD-funded project in the Family Health Centers (FHCs) of NYU Langone Health, a network of federally qualified health centers (FQHC) in NYC that serves over 125,000 low-income and racially and ethnically diverse patients. Project EVIDENCE is a three-phase community-engaged study that uses a multipronged, sequential mixed methods design to gain a comprehensive understanding of the multilevel factors that drive uptake of testing and vaccination for COVID- 19 of Black and Latinx patients (primary outcome), and participation in follow-up care offered by safety-net health systems. Phase 1 is utilizing the FHC electronic health record (EHR) database to quantitatively examine individual-level sociodemographic, clinical, and healthcare utilization factors associated with receiving a PCR test for COVID-19 among 400 Black and Latinx patients who receive care at the FHCs. This phase will also capture the community- and structural-level determinants of testing using validated self-report measures (NIH PhenX Toolkit) among the same patients (Aim 1). In Phase 2 the data sources from Phase 1 are being coupled with qualitative data (e.g., focus groups, ethnographic observation, document analysis) to capture organizational and ethical issues to shed light on important social, cultural, and contextual factors associated with uptake of COVID-19 testing and potential vaccine (Aim 2). In partnership with our Community Oversight Task Force (COTF), in Phase 3, we will integrate Phase 1 and 2 data to refine, test, and disseminate tailored toolkits and ethical governance guidelines (e.g. clinical trials transparency and data privacy) (Aim 3). These toolkits will be designed to increase knowledge and awareness of COVID-19 testing and vaccine research and will be widely disseminated among the FHCs, local community, NYULH, and the RADx UP Coordination and Data Collection Center.

PROJECT NARRATIVE This proposed three-phase mixed methods, community-engaged study is designed to identify multilevel factors that may impede or facilitate COVID-19 testing and anticipatedCOVID-19 vaccine enrollment among the Federally Qualified Health Centers-treated patient population. This provides an unparalleled opportunity to enroll an ethnically diverse, underserved, high-risk patient population, and if successful, this study will provide the first comprehensive information to shed light on important social, cultural, and contextual factors associated with COVID-19 testing disparities and to help prepare for future testing and vaccine initiatives.