PROJECT SUMMARY / ABSTRACT In response to NOT-OD-21-101, the Georgia Center for Diabetes Translation Research (P30DK111024-05S1), a partnership of Emory University (EU), Morehouse School of Medicine (MSM), and Georgia Institute of Technology submits this RADx-UP Supplement proposal titled, “Impact of Community Health Worker Home Deployment on COVID-19 Vaccine Confidence and Uptake.” We propose collaborating with our RADx-UP Diabetes rural community partner and utilizing locally developed and tested Georgia CEAL (1OT2HL156812- 01/16-312-0217571-66105L, PI-Akintobi) COVID-19 communication materials to enhance COVID-19 testing in addition to vaccine confidence and uptake in underserved populations most severely affected by COVID-19 disease (i.e., African Americans and Latinos with diabetes, prediabetes, and their household contacts [“bubble”]). The proposed 1-year project will implement and evaluate a brief Community Health Worker (CHW) intervention through the Albany Area Primary Health Care, a rural Federally Qualified Health Center (FQHC). The primary goal of this study is to maximize effective outreach, education, and communication through CHWs in order to facilitate improved COVID-19 vaccine confidence and uptake in underserved and vulnerable communities. CHWs will be deployed to the homes of adults with increased risk of morbidity and mortality (i.e., African Americans or Latinos with uncontrolled diabetes or prediabetes, age <50 years, and non-COVID-19 vaccinated) in order to educate them about diabetes, COVID-19 and related vaccines. Health assessments, including blood glucose measurement, will be conducted on the indexed patient and offered to all other adult family members in the household (i.e., “bubble”). Adults with Type 2 diabetes likely live in households with other adults who have or are at increased risk for diabetes (i.e., prediabetes and obesity).1 It is expected that they will also share similar COVID-19 exposure risk. The specific aims are to: 1) Evaluate a community-driven education program to increase and enhance COVID-19 vaccine confidence and uptake in individuals with uncontrolled diabetes and their families (i.e., their “bubble”) and 2) Evaluate a community-driven education program to improve diabetes self-management behaviors and related outcomes (e.g., blood glucose) in individuals with uncontrolled diabetes in rural, Southwest Georgia.

PROJECT NARRATIVE Given the elevated risk of severe disease, it is imperative that those with diabetes and prediabetes receive COVID-19 testing, vaccines, and follow recommended guidelines for disease management and/or risk reduction. We will leverage our RADx-UP Diabetes partnership with Albany Area Primary Health Care and its networks to apply evidence-based approaches to evaluate the feasibility of rural area FQHC CHWs to improve diabetes outcomes, COVID-19 vaccine confidence and uptake among adults diagnosed with diabetes and their “bubble.” As with the RADx-UP Diabetes parent project, this supplemental project will also be guided by the EPIS framework, which considers the multilevel nature of healthcare, organizations within systems, and patient needs.