1, 2 It has also highlighted the importance of community partnerships and delivery of services outside of traditional brick-and-mortar health care facilities to mitigate these inequities, especially for people who face access-related barriers to health care. Leveraging pandemic-related public health responses represents an important opportunity for engaging socioeconomically disadvantaged populations into care for diabetes.ĬOVID-19 has laid bare and amplified systemic inequities in health outcomes endured by Latinx and other historically marginalized communities in the US. Acceptability of the rapid testing program was high-98% were satisfied with their visit and 96% said they would return for future services key factors underpinning acceptability included friendly staff, efficiency, and a convenient location.Ĭonclusions and Relevance In this health care improvement study conducted within an existing community-based COVID-19 testing program, integrating rapid testing for diabetes was feasible, reached low-income Latinx individuals, and identified many persons with prediabetes and diabetes, most of whom lacked access to services in formal health care settings. Overall, 313 (33.9%) and 113 (12.2%) individuals had prediabetes and diabetes, respectively only 141 of 354 of these individuals (39.8%) had a primary care clinician whom they had seen in the prior 12 months, which was lower among Latinx individuals (113 of 307 individuals vs 28 of 47 ). Individuals tested for diabetes were more likely to be Latinx (763 of 923 individuals who underwent testing were Latinx vs 3585 of 5708 not undergoing testing), have an annual household income of less than $50 000 (450 individuals vs 2409 individuals ), and not have health insurance (381 individuals vs 1858 individuals ), and 206 (48.0%) had never tested for diabetes before. Results Of 6631 individuals tested (median age 39.3 years 3417 female, 4348 Latinx), 923 (13.9%) underwent hemoglobin A 1c testing with or without COVID-19 testing and 5708 (86.1%) underwent COVID-19 testing only. Main Outcomes and Measures Evaluation was guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework and utilized programmatic data and structured surveys among clients and staff. Interventions Integration of rapid, point-of-care hemoglobin A 1c screening as a testing option in an existing low-barrier COVID-19 testing program.
Because the program was designed to expand access to diabetes screening to the local community, all individuals presenting for on-site testing were eligible. Objective To evaluate outcomes associated with a diabetes testing strategy designed to reach low-income Latinx persons by leveraging COVID-19 testing infrastructure and community trust developed during the COVID-19 pandemic.ĭesign, Setting, and Participants This health care improvement study was conducted from August 1 to October 5, 2021, at an outdoor, community-based COVID-19 testing site at a transport hub in the Mission Neighborhood in San Francisco, California. They also represent a platform that can be leveraged to expand access to testing for chronic diseases, including diabetes, that disproportionately affect the Latinx community and other marginalized communities.
Importance Community-based COVID-19 testing and vaccination programs play a crucial role in mitigating racial and ethnic disparities in COVID-19 service delivery.
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