Evaluating a Community-Led COVID-19 Testing Intervention to Address Mistrust - Study 2
Phase: NA
Conditions: COVID-19, Trust
Sponsor: Old Dominion University

Protocol Version 8, May 8, 2025 
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Title: Evaluating a Community-Led COVID-19 Testing Intervention to Address Mistrust 
 
Funding: NIH 6U01MD018316 
NCT Number: NCT07166770 
Unique Protocol Id: 22-10-FB-0215 - Study 2 
 
Project PIs:  
Kelli England, PhD (MPI) 
Brynn Sheehan, PhD (MPI)  
 
Background 
The U.S. COVID-19 pandemic response has in some ways been an unprecedented 
success; for example, leading a world-wide charge to quickly develop several safe and effective 
COVID-19 vaccines. However, the public health impact of the response has been limited in a 
fundamentally important way—many people strongly mistrust it. In low-income housing settings 
this mistrust intersects with anxiety about perceived consequences exacerbated by 
socioeconomic vulnerability. For example, participants in our ongoing research report that a 
major barrier to COVID-19 testing is the expectation that a positive result will be used against 
them. In this environment, where housing authorities are perceived to have too much power and 
to be highly antagonistic, residents are primarily concerned about the consequences of a 
positive result with respect to employment (e.g., “Are they going to tell my employer?) and 
housing (e.g., “Are they going to make me quarantine away from the rest of my family?”). 
Participants do not seem to think that COVID-19 testing is very useful. This has likely 
contributed to a lack of appreciation for how proactive COVID-19 testing might be used as part 
of a multi-pronged strategy to mitigate the impact of COVID-19 moving forward. And while 
residents have indicated that they might be more amenable to in-home testing due to increased 
privacy, feedback suggests that lack of comfort self-administering rapid tests is another 
significant barrier.  
 
Our Housing Collaborative Community Advisory Board (HC CAB) partners report that our 
relationship(s) with them helped overcome mistrust common in their communities. They 
described the nature of our interactions—which included weekly virtual meetings where we 
discussed current events, both related to and seemingly unrelated COVID and/or healthcare—
led us to be viewed as trustworthy. A central question in discussions on this topic was how to 
replicate this process of trust-building. This study is an attempt to standardize a process of 
relationship and trust building to be used as core components of a COVID-19 testing 
intervention which could be exported and reproduced in other settings.  
 
The Present Study 
In an effort to reproduce the trust built with our community partners and the indirect effect 
that trust seems to have had on beliefs regarding healthcare recommendations, the present 
study aims to implement a community-led intervention with our partner HC CAB members, with 
the goal of increasing trust related to COVID-19 testing. The primary aims of this study are to: 
1. Implement and evaluate a preliminary Peer Mentor COVID-19 testing intervention (see 
Study 1 description below). 
2. Receive feedback from participants and Peer Mentors to identify how the intervention 
could be adapted, and re-run the adapted intervention (see Study 2 description below) 

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The grant funding mechanism that supports the current project also requires the collection of 
common data elements (CDE) as part of our ongoing research partnership with Duke Clinical 
Research Institute (RADX-Up). Please see section Sharing of Data with Duke Clinical Research 
Institute for details.  
 
Study 1: Preliminary Intervention Study 
 
The Peer Mentor model idea stemmed from our partnership with the HC CAB. The Peer Mentor 
model entails Peer Mentors (described fully in the Methods section) meeting weekly for 12 
weeks with their respective Peer Mentees. During these sessions, Peer Mentors and Peer 
Mentees will discuss current events, COVID-19 related health topics, and others, with topics 
being standardized across the Peer Mentors. The Peer Mentor meetings will be conducted via 
zoom, with research team members present at every meeting. Participants who volunteer to 
partake in the study will be randomly assigned to either the Peer Mentor Intervention (n=32) in 
which they will be assigned their Peer Mentor and meet weekly for 12 weeks, or they will be 
assigned to the Control Group (n=32), in which they will not have weekly meetings with a Peer 
Mentor. All participants will complete baseline, 3-month, and 6-month questionnaires assessing 
psychosocial constructs related to COVID-19 testing, vaccination, trust in the government and 
science, experience with discrimination, and response efficacy (see Appendix A-W for a full list 
of questionnaires). Each participant will also be asked to take at-home COVID-19 tests at the 3-
month and 6-month time period. Comfort and trust related to administering the test will also be 
assessed. At the end of the study, all Peer Mentors and participants in the intervention group 
will be asked to provide feedback during one of two feedback sessions focused on how to 
improve the intervention. The current study is unique in that we are attempting to standardize a 
trust building relationship with community members to improve responsiveness and acceptance 
of healthcare recommendations and guidelines.  
 
Method 
 
Participants and Recruitment  
1. HC CAB Members as Peer Mentors. The 18-person HC CAB will make up the potential 
pool of Peer Mentors. We will recruit 8 Peer Mentor participants by announcing the study 
during one of the HC CAB weekly meetings. We will review the requirements and 
expectations of the study, training that Peer Mentors will receive, and compensation. HC 
CAB members interested in being Peer Mentors will contact the research team. 
Research team members will describe the informed consent information, the required 
planning and Peer Mentor virtual meetings, and send the informed consent to be signed. 
The informed consent process will be completed virtually through REDCap. 
Following the completion of the informed consent, the study team will schedule the Peer 
Mentor facilitator training via zoom. Facilitator training is expected to take 2 hours and 
will cover key tenants of respect for persons and ideas, nonjudgmental listening, 
understanding of participants’ rights, practice leading brief discussions, and 
confidentiality.  
a. Peer Mentor inclusion criteria are: 
i. Being a current member of the HC CAB. 
ii. Can commit to a facilitator training session, and a one-hour planning 
meeting and one-hour Peer Mentor meeting each week for 12 weeks.  
 

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2. Intervention (Peer Mentee) & Control Participants: A total of 64 participants (32 per 
group) are needed for the intervention and control groups. In order to plan for attrition, 
incorrect contact information/lost to follow-up, and attention check failures, we are 
requesting approval to recruit up to 120 participants so that we will have approximately 
64 participants (32 participants per group) for study completion. Half of the participants 
will be randomly assigned to be in the Peer Mentee intervention and half of the 
participants will be randomly assigned to the control group. We will only recruit adults 
who live in a low-income housing community managed by one of the following housing 
agencies: (1) Chesapeake Redevelopment and Housing Authority (CRHA), (2) Hampton 
Redevelopment and Housing Authority (HRHA), (3) Newport News Redevelopment and 
Housing Authority (NNRHA), (4) Norfolk Redevelopment and Housing Authority (NRHA), 
(5) Portsmouth Redevelopment and Housing Authority (PRHA), (6) Richmond 
Redevelopment and Housing Authority (RiRHA), (7), Roanoke Redevelopment and 
Housing Authority (RoRHA), (8) Suffolk Redevelopment and Housing Authority (SRHA), 
and (9) Virginia Beach Department of Housing and Neighborhood Preservation 
(VBDHNP). Recruitment will include contacting participants from previous studies who 
indicated an interest in future studies, posting study announcement flyers in HC 
authorities, and through word-of-mouth invitations. The research team will also inform 
each housing community’s tenant advisory board members of the study (contact 
information will be provided by each housing agency).  In the event that we need to 
perform targeted recruitment (e.g., to recruit additional men), we will ask housing agency 
staff for suggestions. Housing authority staff will have no other involvement with 
participants.  
 
Study participants will contact the research team to obtain information about the study 
and confirm eligibility. After confirming that the participant meets inclusion criteria, the 
participant will be added to the list of participants. Once all participants have been 
recruited, stratified randomization will be done to randomize participants by building into 
their respective intervention or control group. Once randomized, participants will be 
emailed their respective informed consent to electronically sign. The informed consent 
process will be completed virtually through REDCap. If the participant has any questions 
while completing the consent form, an investigator or authorized staff can be reached by 
phone to ensure the participant understands the risks and benefits of participating in the 
study. 
a. Intervention/control group participant inclusion criteria are: 
i. Being 18 years or older. 
ii. Being a resident of one of the 9 housing authority agencies. 
iii. Being willing to participate in Zoom meetings and complete online 
assessments as baseline, 3-month, and 6-month timepoints.  
iv. Ability to read, speak, and understand English.  
 
Randomization  
To protect internal validity and eliminate contamination of study groups, we will randomize 
participants into intervention or control group based on building. There is a real probability that 
otherwise, participants (residents) in intervention/control groups will discuss the project with 
others who reside in the same building. Thus, we will utilize stratified randomization by building 
– e.g., if a city’s Housing Authority has two buildings with active participants; one building will be 
randomly assigned as control and the other building will be randomly assigned as intervention.  
 
Peer Mentor Groups 

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Each Peer Mentor (n=8) will be assigned 4 Peer Mentees who they will lead through weekly 
virtual discussions. The virtual meetings will be conducted in pairs such that 2 Peer Mentors will 
meet with 8 Peer Mentees during the weekly meeting. This dual-Peer Mentor meeting is 
planned in the event that one Peer Mentor needs to cancel, the meeting can still be held that 
week. A research team member will be present at every Peer Mentor meeting to observe and 
be available should the Peer Mentors or Peer Mentee participants have any questions.  
 
Planning Meetings 
Virtual planning meetings will be held each week with the research team and the Peer Mentors 
in order to outline the discussion planned for that week. Peer Mentors will be given the 
opportunity to ask questions and ensure they feel comfortable discussing the topic. Planning 
meetings are expected to take 60 minutes.  
 
Peer Mentor Meetings 
Once participants are assigned to the Peer Mentor intervention group, they will be emailed the 
tentative session agenda with zoom links for each meeting. The research team will be available 
to assist with any technical difficulties and/or support. On the scheduled Peer Mentor meeting 
day, participants will log into the zoom meeting and meet for 1-hour with their fellow Peer 
Mentees, Peer Mentor, and research team member. Peer Mentors will guide the group through 
the discussion, with active involvement encouraged from all participants.  
 
Figure 1. Peer Mentor Activities
 
 
 
 
 
 
 
 
 
Meet inclusion criteria 
and consenting 
Facilitator Training 
2-hour Virtual 
Weekly Peer Mentor 
Planning 
Weekly Peer Mentor 
Meetings 
Feedback Sessions 

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Figure 2. Intervention and Control Group Participant Activities 
 
 
 
Data Collection 
 
Questionnaires. All intervention and control group participants will be emailed a REDCap 
survey link to complete at baseline, 3-months, and 6-months. The survey link(s) will be re-sent 
up to 3 times over a 3-week period of time before the survey will be closed for completion. See 
the following for a full list of questionnaires. To assist in maintaining the integrity of data 
 
Meet inclusion criteria 
and consenting 
Randomization 
Control Group 
Intervention Group 
Baseline Assessment 
Weekly Peer Mentor Meetings 
At-Home COVID testing & 3-
Month Assessment 
At-Home COVID testing & 6-
Month Assessment 
Feedback Sessions 

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collected, attention check questions will be mixed throughout the surveys to identify participants 
who are not reading the questions carefully.  
Screening Questionnaire (Appendix A) A basic questionnaire will be used to confirm study 
participation eligibility. 
The PhenX Toolkit (Appendix B) assesses participant COVID-19 knowledge, attitudes, and 
avoidant behaviors. A short version of the toolkit will be included in the present study.  
The Efficacy and Threat Questionnaire (Appendix C) will be used to assess participants’ 
perceived threat and efficacy about COVID-19.  
The God Locus of Health Control scale (Appendix D) is a 6-item assessment focused on 
participants’ belief if God has control over one’s health.    
The Discrimination in Healthcare Scale (Appendix E) is a 7-item assessment of distrust of 
the healthcare system.  
The Conspiracy Belief Scale (Appendix F) is an 8-item scale that will assess participants’ 
general belief in conspiracy theories.  
The Rosenberg Self-Esteem Scale (Appendix G) is a 10-item scale that will measure 
participants’ feelings, positive and negative, about oneself.  
The Self-Efficacy Scale (Appendix H) is a 10-item scale that will be used to measure 
participants’ belief to achieves one’s goals. 
The Brief Self-Control Questionnaire (Appendix I) is a 13-item measure assessing 
participants’ control over one’s behavior.  
The Vaccine Hesitancy Questionnaire (Appendix J). is an 18-item measure that will assess 
participants’ attitudes and beliefs about the COVID-19 vaccine.  
BRIEF Health Literacy Screening Tool (Appendix K) is a 3-item measure that will be used to 
assess participants’ comfort in understanding medical instructions and diagnoses.  
Media Trust (Appendix L) is a 9-item measure created by the research team to assess 
participants’ trust of information from media sources relating to COVID-19. 
Demographics Questionnaire (Appendix M) A basic demographic questionnaire will ask 
participants about their gender, age, race, city of residence, employment, and educational 
attainment. 
The Perceived Stress Scale (Appendix N) is a 10-item scale that will assess participants’ 
perception of stress. 
The Trust Questionnaire (Appendix O) is a measure created by the research team to assess 
participants' trust of information provided by various institutions and individuals relating to 
COVID-19.  
The Anti-Science Scale (Appendix P) is a measure to assess participants’ beliefs and 
attitudes toward the validity of science.  
The Perceived Legitimacy Scale (Appendix Q) is a 22-item scale that will measure 
participants’ view regarding the legitimacy, or trustworthiness, in the norms of institutions, their 
PHA and society as a whole.   
The Brief Sense of Community Scale (Appendix R) is an 8-item scale created to assess 
participants’ feelings about the sense of community in their neighborhood. 

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The Testing Comfort and Confidence Questionnaire (Appendix S) is an 8-item scale created 
by the research team to assess participants’ comfort of COVID-19 tests being conducted by 
different individuals and confidence in proper test-kit handling and understanding of results.  
The Testing Openness Questionnaire (Appendix T) is an 8-item scale created by the 
research team to assess participants’ openness to be tested for COVD-19. 
The Vaccine Intention Questionnaire (Appendix U) is a 7-item scale that will assess the 
participants’ intention of receiving the COVID-19 vaccine.  
The RADXUP CDEs Survey (Appendix V) will be used to assess participants’ understanding 
of pandemic experiences and health impacts of COVID. The items assess knowledge and views 
about social distancing, COVID-19 symptoms and treatment, COVID-19 related testing, vaccine 
status, COVID-19 related impact and health history.  
The Attention Check Questionnaire (Appendix W) are various attention check questions that 
will be mixed throughout the surveys in order to identify participants who are not reading the 
questions carefully. 
 
COVID-19 Tests. Participants will be mailed 2 COVID-19 tests and instructed to take the tests 
at the 3-month and 6-month time period prior to completing the questionnaires. Participants will 
be provided detailed instructions of COVID-19 protocols should they test positive or negative. 
See below for the current protocols per CDC guidelines. 
 
Protocols for Participants Testing Positive for COVID-19 
1. Immediate Isolation: Participants who test positive will be advised to immediately start 
isolation to prevent the spread of the virus, irrespective of their vaccination status or 
symptoms. 
2. Duration of Isolation: 
• 
For asymptomatic cases, isolation begins from the test date (Day 0) with the 
following day being Day 1. 
• 
For symptomatic cases, Day 0 is the onset of symptoms. 
3. Reassessment of Symptoms: If a participant develops symptoms within 10 days of 
testing, the isolation period restarts from the day symptoms appear. 
4. End of Isolation: Specific criteria for ending isolation will be based on the latest CDC 
guidance, including the resolution of symptoms and passage of the recommended 
isolation period. 
Protocols for Participants Testing Negative for COVID-19 
1. End of Isolation: Participants who test negative and do not exhibit symptoms can end 
their isolation immediately; or resume normal activity. 
2. Monitoring: We will continue to monitor these participants for any subsequent 
development of symptoms and advise retesting if necessary. 
Additional Resources 
• 
Education and Support: All Peer Mentees and Control participants will receive 
comprehensive information and support on how to effectively isolate, monitor symptoms, 
and seek medical attention if necessary. 
• 
Updates on Guidelines: We will regularly update these protocols to reflect any changes 
in the CDC guidelines or public health recommendations. 

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Our aim is to ensure the health and safety of all participants while maintaining the integrity of 
our study. We believe these protocols, in alignment with CDC guidelines, provide a robust 
framework for managing COVID-19 risks among our study participants. 
Feedback Sessions 
 
We expect that intervention adaptation will likely be required. For example, a combination of 
one-on-four peer mentor support provided by community members coupled with larger group 
discussions with academic partners might be an ideal combination for building trust. As such, to 
fulfill Aim 2 of the present study, participants will be invited to participate in feedback sessions 
about the Peer Mentor intervention. Discussion questions will center on participant experiences 
in the study that would not necessarily have been captured during the quantitative assessment. 
Our goal will be to include all 32 Peer Mentee participants and all 8 Peer Mentors (in two 
separate sessions). We will ask questions related to the following prompts:  
 
1. What have you liked the most about being in the study? 
2. What have you disliked about being in the study?  
3. What did you like or not like about the virtual format of the study?  
4. Would in-person sessions make you feel more or less comfortable?   
5. Did the tablets and technical support help make you more comfortable sharing 
things with us?    
6. How did being in the study change how you feel about COVID-19 testing? 
 
Compensation. All participants (peer mentors, peer mentees, and control) will be paid using 
reloadable prepaid cards. The reloadable cards enable repeated payments and are most 
efficient and economical for studies in which participants are paid repeatedly throughout the 
duration of a study.  
 
Peer Mentors. In order to support the required weekly digital connectivity with participants, Peer 
Mentors will receive an Apple iPad and will also be compensated $20 for each study activity 
(each planning meeting, each Peer Mentor meeting, and the feedback session). As part of the 
HC CAB, peer mentors are already provided with internet connectivity and technical support 
from the research team.  
 
Peer Mentees. In order to support the required weekly digital connectivity with participants 
assigned to the Peer Mentor intervention group, these participants will receive Samsung tablets 
with HD webcams, internet connectivity for the duration of the study, and basic digital literacy 
instruction and technical support. They will also be compensated $20 for each study activity 
(each Peer Mentor meeting, each data collection period, and the feedback session).  
 
Control Group. Control group participants will be compensated $20 for each study activity 
(each data collection period). 
 
 

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Please see the table below for a breakdown of participant payment by participant type. 
 
Payment Breakdown 
Activity 
Payment 
per activity 
Peer 
Mentor 
Total 
Participant 
Total 
Control 
Total 
Weekly Meeting (12) 
$20 
$240 
$240 
$0 
Weekly Planning Meeting 
(12) 
$20 
$240 
$0 
$0 
Surveys (baseline, COVID-19 
test and 3-month 
assessment, COVID-19 test 
and 6-month assessment) 
$20 
$0 
$60 
$60 
RADX-Up Assessment 
$20 
$0 
$20 
$20 
Feedback session (1) 
$20 
$20 
$20 
$0 
Total compensation based 
on role 
 
$500 
$340 
$80 
 
 
Tablet Usage Agreement  
 
Each participant in an intervention group will be asked to review and sign a Tablet Usage 
Agreement (See Appendix X) before they are provided with their tablet and internet service. The 
tablets (Samsung Galaxy Tab A or similar) will be for the participants to keep, regardless of 
whether they continue to participate. However, internet service (unlimited data from T-Mobile, 
11GB of hotspot data per month) will only be provided for the duration of the study to active 
participants who do not miss more than two study activities during any 30-day period.  
 
 
Risks and Benefits 
 
Participants have the potential to benefit from their study participation by using the tablets 
and internet service that we will provide for non-research purposes, such as telework or for 
interacting with family and friends. 
 
We anticipate that conducting the feedback sessions and the administration of survey 
questionnaires and other measures represent only minimal risk to participants and that the 
greatest potential risks to participants involve privacy and confidentiality. Raw data will contain 
participant identifiers. However, steps will be taken to safeguard this information. Questionnaire 
data will be completed and stored in REDCap. 
 
Only the research team will have access to raw data on REDCap. Raw data will be 
downloaded and de-identified before analysis. Only aggregate results will be disseminated.   
 
Videos of Peer Mentor sessions will be created using the “record” command in Zoom and 
will be saved on a secure EVMS server. The videos will be saved for the duration of the study 
and accessed only on an as needed basis.  
 
We have also incorporated safeguards to reduce the impact of related harms if a breach of 

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confidentiality should occur. Most importantly, partner PHAs have agreed that study data or 
study involvement will not be used against participants in the event of an accidental disclosure. 
This includes instances when participants might disclose their involvement in the study and 
study information to PHA staff on their own. 
 
 
Sharing of Data with Duke Clinical Research Institute (RADX-Up) 
 
As part of our ongoing research with the Duke Clinical Research Institute (RADX-Up), and in 
compliance with the requirements set forth by our funding agency, we will include Common 
Data Elements (CDE) in our study. These CDEs include 130 items assessing demographic 
information, health status, and questions regarding attitudes about COVID-19 behaviors and 
guidance. The CDEs are intended to standardize data collection across studies, facilitating 
broader data analysis and comparison. This integration supports our aim to contribute to a 
larger dataset that enhances the value and impact of research in our field. 
At the time of informed consent, participants will also be presented with a separate informed 
consent to complete CDEs. This will ensure that participants are fully informed about the nature 
of these questions and the purpose behind them. Participation in the CDE component of the 
study is entirely voluntary. Participants will be informed that they have the right to decline to 
answer these questions without any impact on their participation in the rest of the study. The 
CDE questions will be administered at the three-month mark of the study. These questions will 
be included as part of a questionnaire sent to participants through REDCap. All data collected 
through these questions will be handled in accordance with our existing data use and sharing 
agreements with RADX-Up. We are committed to maintaining the highest level of confidentiality 
and will ensure that all data is stored and shared in compliance with NIH and HIPAA. 
The integration of CDE questions into our study is a critical component of our commitment to 
contributing valuable data to the wider research community. We believe that with the proper 
consent process and data handling protocols, we can effectively implement this aspect of the 
study without compromising participant privacy or data integrity. 
 
Study 2: Adapted Intervention Study 
This grant included among its aims to re-run the Peer Mentor Invention study after revising it 
based on participant feedback and lessons learned from the first study. Thus, Study 2 below 
includes specifics on the methods of our revised intervention study. Study 2 is identical to Study 
1, with the following changes based on participant feedback and lessons learned with Study 1:  
• 
The sessions will run for 14 weeks instead of 12 weeks to better allow for getting to 
know one another and sharing community resources, discussion of health and aging, 
reflection on progress and health planning for the future   
• 
The sessions will each be 75 minutes instead of 60 minutes 
• 
A few questionnaires have been added; a few others eliminated 
• 
Compensation has been increased to $25 per activity (vs $20 per activity) due to the 
small increase in time commitment 
• 
Time 3 follow-up time has been reduced to 1-month post-intervention 
• 
Randomization by building will happen prior to recruitment, so recruitment flyers and 
communications in buildings can provide detailed information specific to condition  

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• 
Our study N size for Study 2 will be 56, to include 6 peer mentors, 25 control group, and 
25 intervention group participants 
• 
With the exception of Peer Mentors (6), Study 2 participants cannot have participated in 
Study 1 
• 
There will be no feedback sessions 
• 
The RadX-Up sub study has concluded and will not be a part of Study 2 (no data 
sharing) 
 
Method 
 
Participants and Recruitment  
1. HC CAB Members as Peer Mentors. The 15-person HC CAB will make up the potential 
pool of Peer Mentors. Study 1 peer mentors are eligible to be peer mentors in Study 2, 
but we will prioritize any interested CAB members who did not have the opportunity to 
participate in Study 1. We will recruit 6 Peer Mentor participants by announcing the study 
during one of the HC CAB weekly meetings. We will review the requirements and 
expectations of the study, training that Peer Mentors will receive, and compensation. HC 
CAB members interested in being Peer Mentors will contact the research team. 
Research team members will describe the informed consent information, the required 
planning and Peer Mentor virtual meetings, and send the informed consent to be signed. 
The informed consent process will be completed virtually through REDCap. 
 
Following the completion of the informed consent, the study team will schedule the Peer 
Mentor facilitator training via zoom. Facilitator training (See Appendix AD) is expected to 
take 2 hours and will cover key tenants of respect for persons and ideas, nonjudgmental 
listening, understanding of participants’ rights, practice leading brief discussions, and 
confidentiality.  
a. Peer Mentor inclusion criteria are: 
i. Being a current member of the HC CAB. 
ii. Can commit to a facilitator training session, and a one-hour planning 
meeting and 75-minute Peer Mentor meeting each week for 14 weeks.  
 
2. Intervention (Peer Mentee) & Control Participants: A total of 50 participants (25 per 
group) are needed for the intervention and control groups. Half of the participants will be 
randomly assigned to be in the Peer Mentee intervention and half of the participants will 
be randomly assigned to the control group. We will only recruit adults who live in a low-
income housing community or receive a housing choice voucher from one of the 
following housing agencies: (1) Chesapeake Redevelopment and Housing Authority 
(CRHA), (2) Hampton Redevelopment and Housing Authority (HRHA), (3) Newport 
News Redevelopment and Housing Authority (NNRHA), (4) Norfolk Redevelopment and 
Housing Authority (NRHA), (5) Portsmouth Redevelopment and Housing Authority 
(PRHA), (6) Richmond Redevelopment and Housing Authority (RiRHA), (7), Roanoke 
Redevelopment and Housing Authority (RoRHA), (8) Suffolk Redevelopment and 
Housing Authority (SRHA), and (9) Virginia Beach Department of Housing and 
Neighborhood Preservation (VBDHNP). Recruitment will include contacting participants 
from previous studies who indicated an interest in future studies, posting study 
announcement flyers in HC authorities, and through word-of-mouth invitations. The 
research team will also inform each housing community’s tenant advisory board 

Protocol Version 8, May 8, 2025 
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members of the study (contact information will be provided by each housing agency).  In 
the event that we need to perform targeted recruitment (e.g., to recruit additional men), 
we will ask housing agency staff for suggestions. Housing authority staff will have no 
other involvement with participants.  
 
Study participants will contact the research team or complete an online screener to 
obtain information about the study and confirm eligibility. After confirming that the 
participant meets inclusion criteria, participants will be emailed their respective informed 
consent to electronically sign. The informed consent process will be completed virtually 
through REDCap. If the participant has any questions while completing the consent 
form, an investigator or authorized staff can be reached by phone to ensure the 
participant understands the risks and benefits of participating in the study. 
a. Intervention/control group participant inclusion criteria are: 
i. Being 18 years or older. 
ii. Being a resident or voucher recipient of one of the 9 housing authority 
agencies. 
iii. Being willing to participate in weekly Zoom meetings (for intervention 
group only) and complete online assessments at baseline, 14-week 
immediate post-intervention, and 1-month follow-up timepoints.  
iv. Ability to read, speak, and understand English.  
v. Having not participated in Study 1. 
 
Randomization  
To protect internal validity and eliminate contamination of study groups, we will randomize 
participants into intervention or control group based on building. There is a real probability that 
otherwise, participants (residents) in intervention/control groups will discuss the project with 
others who reside in the same building. Thus, we will utilize stratified randomization by building 
– e.g., if a city’s Housing Authority has two buildings with active participants; one building will be 
randomly assigned as control and the other building will be randomly assigned as intervention. 
Randomization by building will happen prior to recruitment, so recruitment flyers and 
communications in buildings can provide detailed information specific to condition. 
 
Peer Mentor Groups 
Each Peer Mentor (n=6) will be paired with another Peer Mentor and together, the pair of peer 
mentors will be assigned 7-10 Peer Mentee participants. The Peer Mentors will lead the mentee 
participants through weekly virtual discussions (see weekly discussion topics in Appendix AE). 
This dual-Peer Mentor meeting is planned in the event that one Peer Mentor needs to cancel, 
the meeting can still be held that week. A research team member will be present at every Peer 
Mentor meeting to observe and be available should the Peer Mentors or Peer Mentee 
participants have any questions.  
 
Planning Meetings 
Virtual planning meetings will be held each week with the research team and the Peer Mentors 
in order to outline the discussion planned for that week. Peer Mentors will be given the 
opportunity to ask questions and ensure they feel comfortable discussing the topic. Planning 
meetings are expected to take 60 minutes or less.  
 
Peer Mentor Meetings 

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For participants assigned to the Peer Mentor intervention group, they will be emailed the 
tentative session agenda (see Appendix AE) with zoom links for each meeting. The research 
team will be available to assist with any technical difficulties and/or support. On the scheduled 
Peer Mentor meeting day, participants will log into the zoom meeting and meet for 75 minutes 
with their fellow Peer Mentees, Peer Mentors, and research team member. Peer Mentors will 
guide the group through the discussion, with active involvement encouraged from all 
participants.  
 
See Figure 3 for an overview of Peer Mentor participant activities, and Figure 4 for an overview 
of intervention and control group participant activities. 
 
Figure 3. Peer Mentor Activities
 
 
 
 
 
 
 
 

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Figure 2. Intervention and Control Group Participant Activities 
 
 
 
Data Collection 
 
Questionnaires. All intervention and control group participants will be emailed a REDCap 
survey link to complete at baseline (Time 1), 14 weeks (Time 2), and 18 weeks (Time 3). The 
survey link(s) will be re-sent up to 3 times over a 3-week period of time before the survey will be 
closed for completion.  
Study 2 surveys are identical to the surveys from Study 1, except for the following additions and 
deletions, based on our experience with Study 1:  

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• 
The screening questionnaire was modified for Study 2 
• 
Phoenix Toolkit was reduced to only 2 questions 
• 
Media Trust scale was eliminated 
• 
RADX-Up CDEs survey was eliminated 
• 
Additional measures were added to assess food literacy, social connectedness, social 
isolation, health literacy, growth mindset, loneliness, and access to necessities   
 
See the following for a full list of questionnaires. To assist in maintaining the integrity of data 
collected, attention check questions will be mixed throughout the surveys to identify participants 
who are not reading the questions carefully.  
 
Screening Questionnaire (Appendix A) A basic questionnaire will be used to confirm study 
participation eligibility. 
Demographics Questionnaire (Appendix B) A basic demographic questionnaire will ask 
participants about their gender, age, race, city of residence, employment, and educational 
attainment. 
The PhenX Toolkit (Appendix C) assesses participants’ COVID-19 vaccination status. 
The Efficacy and Threat Questionnaire (Appendix D) will be used to assess participants 
perceived threat and efficacy about COVID-19.  
The God Locus of Health Control scale (Appendix E) is a 6-item assessment focused on 
participants’ belief if God has control over one’s health.    
The Discrimination in Healthcare Scale (Appendix F) is a 7-item assessment of distrust of 
the healthcare system.  
The Conspiracy Belief Scale (Appendix G) is an 8-item scale that will assess participants’ 
general belief in conspiracy theories.  
The Rosenberg Self-Esteem Scale (Appendix H) is a 10-item scale that will measure 
participants’ feelings, positive and negative, about oneself.  
The Self-Efficacy Scale (Appendix I) is a 10-item scale that will be used to measure 
participants’ belief to achieve one’s goals. 
The Brief Self-Control Questionnaire (Appendix J) is a 13-item measure assessing 
participants’ control over one’s behavior.  
The Vaccine Hesitancy Questionnaire (Appendix K). is an 18-item measure that will assess 
participants’ attitudes and beliefs about the COVID-19 vaccine.  
BRIEF Health Literacy Screening Tool (Appendix L) is a 3-item measure that will be used to 
assess participants’ comfort in understanding medical instructions and diagnoses.  
The Perceived Stress Scale (Appendix M) is a 10-item scale that will assess participants’ 
perception of stress. 

Protocol Version 8, May 8, 2025 
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The Trust Questionnaire (Appendix N) is a measure created by the research team to assess 
participants' trust of information provided by various institutions and individuals relating to 
COVID-19.  
The Anti-Science Scale (Appendix O) is a measure to assess participants’ beliefs and 
attitudes toward the validity of science.  
The Perceived Legitimacy Scale (Appendix P) is a 22-item scale that will measure 
participants’ view regarding legitimacy, or trustworthiness, in the norms of institutions, their PHA 
and society as a whole.   
The Brief Sense of Community Scale (Appendix Q) is an 8-item scale created to assess 
participants’ feelings about the sense of community in their neighborhood. 
The Testing Comfort and Confidence Questionnaire (Appendix R) is an 8-item scale 
created by the research team to assess participants’ comfort of COVID-19 tests being 
conducted by different individuals and confidence in proper test-kit handling and understanding 
of results.  
The Testing Openness Questionnaire (Appendix S) is an 8-item scale created by the 
research team to assess participants’ openness to be tested for COVD-19. 
The Vaccine Intention Questionnaire (Appendix T) is a 7-item scale that will assess the 
participants’ intention of receiving the COVID-19 vaccine.  
The Attention Check Questionnaire (Appendix U) are various attention check questions that 
will be mixed throughout the surveys in order to identify participants who are not reading the 
questions carefully. 
A Short Food Literacy Questionnaire (SFLQ) for Adults (Appendix V) is a 12-item 
questionnaire that assesses a participant's knowledge of food nutrition.  
Social Connectedness Scale Revised (Appendix W) is a 20-item revised scale that 
measures a participant's feeling towards other people and their community. 
Social Isolation Scale (Appendix X) is a 6-item scale that measures disconnected a 
participant feels from others 
The 14-item Health Literacy Scale (HLS-14) for Adults (Appendix Y) is a scale that 
measures an individual's ability to understand, access, and apply health-related information. 
This scale was tailored in context of American adults.  
The Growth Mindset Scale (Appendix Z) is an 8-item scale that will measure an individual’s 
mindset about learning and their ability to improve skills through effort. 
The UCLA Loneliness Scale (Version 3) (Appendix AA) is a 20-item scale that will assess a 
participant's perceived isolation and loneliness.  
The Necessities Index (Appendix AB) is a 10-item scale for measuring the material and social 
conditions necessary for adolescents to thrive which was updated and tailored for an adult 
population.  
 

Protocol Version 8, May 8, 2025 
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COVID-19 Tests. Participants will be mailed 2 COVID-19 tests and instructed to take the tests 
at the 14-week (Time 2) and 18-week (Time 3) time period prior to completing the 
questionnaires. Participants will be provided detailed instructions of COVID-19 protocols should 
they test positive or negative. See below for the current protocols per CDC guidelines. 
 
Protocols for Participants Testing Positive for COVID-19 
1. Immediate Isolation: Participants who test positive will be advised to immediately start 
isolation to prevent the spread of the virus, irrespective of their vaccination status or 
symptoms. 
2. Duration of Isolation: 
• 
For asymptomatic cases, isolation begins from the test date (Day 0) with the 
following day being Day 1. 
• 
For symptomatic cases, Day 0 is the onset of symptoms. 
3. Reassessment of Symptoms: If a participant develops symptoms within 10 days of 
testing, the isolation period restarts from the day symptoms appear. 
4. End of Isolation: Specific criteria for ending isolation will be based on the latest CDC 
guidance, including the resolution of symptoms and passage of the recommended 
isolation period. 
Protocols for Participants Testing Negative for COVID-19 
3. End of Isolation: Participants who test negative and do not exhibit symptoms can end 
their isolation immediately; or resume normal activity. 
4. Monitoring: We will continue to monitor these participants for any subsequent 
development of symptoms and advise retesting if necessary. 
Additional Resources 
• 
Education and Support: All Peer Mentees and Control participants will receive 
comprehensive information and support on how to effectively isolate, monitor symptoms, 
and seek medical attention if necessary. 
• 
Updates on Guidelines: We will regularly update these protocols to reflect any changes 
in the CDC guidelines or public health recommendations. 
 
Our aim is to ensure the health and safety of all participants while maintaining the integrity of 
our study. We believe these protocols, in alignment with CDC guidelines, provide a robust 
framework for managing COVID-19 risks among our study participants. 
 
Compensation  
All participants (peer mentors, peer mentees, and control) will be paid using reloadable prepaid 
cards. The reloadable cards enable repeated payments and are most efficient and economical 
for studies in which participants are paid repeatedly throughout the duration of a study.  
 
Peer Mentors. In order to support the required weekly digital connectivity with participants, Peer 
Mentors will use their Apple iPad (provided to all HC CAB members) and will also be 
compensated $25 for each study activity (each planning meeting and each Peer Mentor 
meeting). As part of the HC CAB, peer mentors are already provided with internet connectivity, 
Apple iPad, and technical support from the research team.  
 

Protocol Version 8, May 8, 2025 
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Peer Mentees. In order to support the required weekly digital connectivity with participants 
assigned to the Peer Mentor intervention group, these participants will receive Samsung tablets 
with HD webcams (or similar), internet connectivity for the duration of the study, and basic 
digital literacy instruction and technical support. They will also be compensated $25 for each 
study activity (each Peer Mentor meeting and each data collection period).  
 
Control Group. Control group participants will be compensated $25 for each study activity 
(each data collection period). 
 
Please see the table below for a breakdown of participant payment by participant type. 
 
Payment Breakdown 
Activity 
Payment 
per 
activity 
Peer 
Mentor 
Total 
Intervention 
Total 
Control 
Total 
Weekly Meeting (14) 
$25 
$350 
$350 
$0 
Weekly Planning Meeting (14) 
$25 
$350 
$0 
$0 
Surveys (baseline, COVID-19 test and 
14-week assessment, COVID-19 test 
and 18-week assessment) 
$25 
$0 
$75 
$75 
Total compensation based on role 
 
$700 
$425 
$75 
 
 
Tablet Usage Agreement  
 
Each participant in an intervention group will be asked to review and sign a Tablet Usage 
Agreement (See Appendix AC) before they are provided with their tablet and internet service. 
The tablets (Samsung Galaxy Tab A or similar) will be for the participants to keep, regardless of 
whether they continue to participate. However, internet service (unlimited data from T-Mobile, 
11GB of hotspot data per month) will only be provided for the duration of the study to active 
participants who do not miss more than two study activities during any 30-day period.  
 
 
Risks and Benefits 
 
Participants have the potential to benefit from their study participation by using the tablets 
and internet service that we will provide for non-research purposes, such as telework or for 
interacting with family and friends. 
 
We anticipate that conducting the feedback sessions and the administration of survey 
questionnaires and other measures represent only minimal risk to participants and that the 
greatest potential risks to participants involve privacy and confidentiality. Raw data will contain 
participant identifiers. However, steps will be taken to safeguard this information. Questionnaire 
data will be completed and stored in REDCap. 
 
Only the research team will have access to raw data on REDCap. Raw data will be 
downloaded and de-identified before analysis. Only aggregate results will be disseminated.   
 
Videos of Peer Mentor sessions will be created using the “record” command in Zoom and 
will be saved on a secure EVMS server. The videos will be saved for the duration of the study 

Protocol Version 8, May 8, 2025 
Page 19 
 
 
and accessed only on an as needed basis.  
 
We have also incorporated safeguards to reduce the impact of related harms if a breach of 
confidentiality should occur. Most importantly, partner PHAs have agreed that study data or 
study involvement will not be used against participants in the event of an accidental disclosure. 
This includes instances when participants might disclose their involvement in the study and 
study information to PHA staff on their own. 
 
 
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