Co-Creating a Culturally Tailored COVID-19 Testing Program in the San Ysidro US/Mexico Border Region

LINDA SALGIN, MPH, CPH
San Ysidro Health

Racial and ethnic disparities in COVID-19 incidence are pronounced among underserved Latino, Black, Indigenous, and People of Color (BIPOC) communities. These communities comprise a disproportionate percentage of workers in essential industries and experience more housing insecurity and live in multigenerational households which increases risk of COVID-19 infection and transmission. Among US/Mexico border communities, such as San Ysidro, California, these factors can be exacerbated by lack of access to testing. We partnered with a Federally Qualified Health Center (FQHC) in San Ysidro and engaged with multiple stakeholders consisting of community members, community health center partners, and academic research partners to conduct a needs assessment and co-create a culturally-tailored COVID-19 testing program for border communities with a specific focus on prenatal and pediatric patients and their support systems (e.g., individuals that accompany both pediatric and prenatal patients when accessing healthcare services).

The study sample was recruited from the patient population within a FQHC in San Ysidro. Participants were recruited into three cohorts 1) prenatal patients, 2) pediatric patients and 3) supporters or caregivers of both prenatal and pediatric patients. Target sample size for each cohort was 50 participants.

A cross-sectional survey was used to collect information on experiences accessing COVID-19 testing and perceived risk of COVID-19 infection within the San Ysidro community between December 29, 2020 through April 2, 2021. These data were drawn from the larger study Community-driven Optimization of COVID-19 testing to Reach and Engage underserved Areas for Testing Equity (CO-CREATE) study funded through the National Institutes of Health Rapid Acceleration of Diagnostics for Underserved Population (RADx-UP) initiative.

A total of 179 surveys were analyzed. Most participants identified as female (85%) and as Mexican/Mexican American (75%). Over half (56%) were between the age of 25-34 years old. Perceived Risk: 37% rated their risk of acquiring COVID-19 as moderate to high whereas 50% rated their risk of getting COVID-19 as low to none. Testing Experience: Approximately 68% indicated they had previously been tested for COVID-19. Among those having been tested, 97% reported having very easy or easy access to testing for COVID-19. Reasons for not testing included limited appointment availability, cost concerns, not feeling sick, and concern about risk of infection while at a testing facility.

This study is an important first step to understand the COVID-19 risk perceptions and testing access among patients and community members living near the US/Mexico border in San Ysidro, California. These findings informed the iterative design of the RADx-UP testing program, CO-CREATE, which offers walk-up testing at a FQHC at no cost to participants.