Brown researchers, local partners aim to reduce disparities in COVID-19 vaccination, testing

With $1.4 million in new grant support from the National Institutes of Health, Brown University researchers and local community organizations are working to address barriers to COVID-19 testing and vaccination among the Latinx population as well as high-risk children in Rhode Island.

The project is designed to address disparities in access to health care in the U.S. brought to the forefront by the COVID-19 pandemic, the researchers noted. Underserved communities, including Hispanic and Latinx populations, tend to have lower rates of vaccinations even in a state like Rhode Island, which has higher-than-average vaccination rates.

“As we are anticipating that vaccinations will soon be available and FDA-approved for children, this project is extremely timely,” said project leader Dr. Sharon Rounds, associate dean for clinical affairs at Brown and a professor of medicine. At the same time, testing remains an essential tool in addressing outbreaks, she said.

The projects have both launched and will be funded for up to two years.

The funds are part of an initiative aimed at reducing disparities in underserved populations, who are disproportionately affected by COVID-19. The overarching goal of the NIH’s Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) initiative is to understand and ameliorate factors that place a disproportionate burden of the pandemic on vulnerable populations, specifically by implementing programs that expand the scope and reach of COVID-19 testing interventions to reduce these disparities.

The new funding to Brown marks the second phase of a RADx-UP grant to the University in partnership with Progreso Latino, a nonprofit that serves Rhode Island’s Latinx and immigrant communities, and the Rhode Island Quality Institute, which collects and analyzes health care data from across the state.

The prior phase of the program focused on building a research infrastructure to understand testing hesitancy among Hispanic and Latinx communities in Rhode Island, said Neil Sarkar, a Brown faculty member who leads the Rhode Island Quality Institute. Researchers from Brown and its project partners identified areas in Rhode Island with insufficient COVID-19 testing and vaccination rates. To better understand attitudes about and barriers to testing, Progreso Latino helped the RADx-UP team recruit and train a corps of community health workers, or promotoras, to lead focus groups with community members and with providers at clinics that serve Hispanic and Latinx patients in Providence and beyond.

The next phase of research — enabled by the new funding — involves two arms, Sarkar explained. One is expanding the scope of work with Progreso Latino to understand barriers to vaccinations and testing, including access and hesitancy. The other is expanding the study population to include high-risk children — those who reside in medically underserved communities or have special health care needs. Brown will continue to collaborate with the Rhode Island Quality Institute as well as with the Rhode Island Parent Information Network, a nonprofit that assists families with challenges like navigating health care or special education.

Brown experts in biomedical informatics and biostatistics will work with community partners to interpret the data, said Sarkar, an associate professor of medical science and of health services, policy and practice at Brown.

“This is a truly a partnership between the community groups and the experts in biomedical informatics and public health at Brown’s Warren Alpert Medical School and School of Public Health,” Rounds said. “We hope this partnership will help us understand patterns of hesitancy regarding COVID testing and vaccination and, crucially, determine ways in which we can overcome those barriers and increase the participation of these vulnerable populations.”

Sarkar notes that unlike other studies that involve long lead times and sequential steps, this one is an operational project. “What’s exciting is that we’re building the infrastructure and using it as we go along,” he said. The project is bridging qualitative and quantitative research analyses, then reacting to the findings, developing methods to address identified issues and continually testing and refining the entire process.

While mitigating the spread of COVID-19 is the goal of this project, Sarkar said that the infrastructure the RADx-UP team is developing can be used to address other conditions that impact the health of underserved communities, such as diabetes or certain types of cancer.

“COVID is the latest example of the disparities in our health system, but it wasn’t the first and won’t be the last,” Sarkar said. “There are many other health challenges faced by underserved communities, and our hope that is that research infrastructure and partnerships with the community organizations developed through this project will help us make progress in other clinical domains.”

In addition to Rounds and Sarkar, other Brown project leads include Philip Chan, Elizabeth Chen, Yovanska Duete-Velez, Joseph Hogan, Amy Nunn and Anashua Rani Ghose Elwy.

The University applied for this award through Advance-CTR, a Brown-based statewide hub for clinical and translational research resources in Rhode Island.

It is supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number U54GM115677.