Implementation of COVID-19 Testing Strategies in Community Health Centers

Study Overview
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Brief Summary
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This project is part of a competitive revision to accelerate COVID-19 testing in underserved populations. The overall aim is to implement strategies to expand COVID testing in hotspot communities in MA, through 6 community health center (CHC)-community partnerships. A base strategy will be implemented at all sites. A tailored strategy unique to local populations will be added and tested in a stepped wedge design.

Official Title
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Implementation of COVID-19 Testing Strategies in Community Health Centers

Conditions
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Covid19

Intervention / Treatment
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* Other: RADx CHCs testing intervention strategy
* Other: Usual care control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants are patients at the intervention or control CHCs or members of the local community. The participating sites constitute one group; a set of matched control CHCs that will conduct testing as usual constitute the second group. Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: RADx CHCs testing intervention strategy<br>Six Massachusetts community health center partnerships implementing both a common testing expansion implementation strategy plus tailored strategies designed for community partner needs. | Other: RADx CHCs testing intervention strategy<br>* The study team will support partner CHCs to implement workflows with some combination of dedicated testing staff, off-site testing, outreach/communications to priority populations, and linkage with local contact tracing systems. Implementation support will take the form of practice facilitation, rapid cycle testing (by supporting CHCs to review their internal data to assess the impact of workflow changes), and expert consultation from the research team on testing technology and testing location design.<br>|
| Other: Usual care control<br> | Other: Usual care control<br>* CHCs implement testing strategies in accordance with their usual supports.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage Change in Testing During the Study Compared to Tests Completed Prior to Study Start | Acceleration of covid testing volume during covid surges, estimated as the percent change in weekly covid testing volume trend for each 10% increase in covid cases. A slope value was estimated from a segmented regression model for the entire study period, which was then used to calculate a difference between the post- and pre-implementation periods. | 85 weeks post-implementation compared to 35 weeks pre-implementation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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implementation science, community health center