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Sunday, June 4, 2023

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A student received a COVID-19 vaccine at Student Health Services in February. (Photo: Gary Payne) A student received a COVID-19 vaccine at Student Health Services in February. (Photo: Gary Payne)

Partnerships Expand COVID-19 Outreach to Schools, Homes, Communities

The SDSU School of Public Health is teaming up with a local school district for a $4 million NIH-funded outreach program.
By Jeff Ristine

Three new federal grants to San Diego State University researchers and community partners, totaling more than $9 million, are expanding SDSU’s already major role in outreach to fight the spread of COVID-19.

Focused on high-risk communities and schools, the grants will bring at-home COVID-19 testing to thousands of middle-school students, teachers, staff and their families, support efforts to expand vaccinations, and explore individualized intervention strategies to prevent COVID-19 transmission in households.

Here’s how each project aims to address the pandemic:

Fighting COVID-19 in Schools

The SDSU School of Public Health will launch an in-home COVID-19 testing program in partnership with Sweetwater Union High School District and other community partners.

A $4 million, two-year award from the National Institutes of Health (NIH) will bring regular COVID-19 testing into homes as an adjunct to on-site testing, both as a preventive measure and to collect data on whether such at-home testing works to avert COVID-19 transmission. Kits will be provided free to volunteers at 11 middle schools in the Sweetwater district.

Announced July 21, “Communities Fighting COVID! Returning Our Kids Back to School Safely” is part of the NIH RADx-UP Return to School Diagnostic Testing Approaches Initiative. SDSU is one of 16 institutions across the U.S. selected to participate.

It comes on the heels of the July announcement of a pilot project exploring the feasibility of at-home-testing for family members of students at Southwest Middle School in San Diego’s Nestor community. That South Bay project will help SDSU researchers refine materials and strategies for the broader effort.

“For the most part no one’s really doing at-home testing for schools,” said Susan Kiene, professor of global health and lead principal investigator on the grant. One aim is to determine how participation rates compare to on-site testing, using different methods at different schools.

The other goal is prevention. “If you’re doing at-home testing,” Kiene said, “you’re catching the infection before people have a chance to expose other people in the school community” as well as others in the family unit. Preventing in-school exposure will help to keep schools open and kids in classrooms as they return to full capacity. The researchers are hopeful that the program will also boost parent confidence in the return to in-person learning.

Focusing on those who are unvaccinated or medically vulnerable, researchers expect to reach as many as one out of every five students and staff members per school.

If each participant adds a family member to the project, that would allow for regular testing of at least 4,000 unvaccinated volunteers districtwide, Kiene said; the tests are appropriate for siblings as young as 2 years old. In addition to testing, the project will include other COVID-19 mitigation efforts, including vaccination events at the schools.

SDSU’s Communities Fighting COVID! team has collaborated since March with the Sweetwater district to make on-site COVID testing available at several of the district schools, encompassing several predominantly underserved and Latinx populations that have been heavily impacted by the COVID-19 pandemic.

“As our district opens to in-person instruction, we must remain vigilant about the spread of COVID-19 and its variants,” said Vernon Moore, chief of educational equity and support services at Sweetwater Union High School District. “This extraordinary research partnership with SDSU provides our schools and surrounding communities with another layer of virus mitigation through testing our students and families.”

Corinne McDaniels-Davidson, director of the Institute for Public Health at SDSU, and Eyal Oren, interim director of the School of Public Health, are co-principal investigators on the grant. Community partners include Alliance Health Clinic, South Bay Community Services and the Asian Pacific Islander Initiative.

Fighting COVID-19 in Households

In a $4.2 million grant from the National Institute on Minority Health and Health Disparities, the School of Public Health and Family Health Centers of San Diego will test specially tailored intervention strategies to stop the spread of COVID-19 in households where one family member already is infected.

“We’re going to look at various ways that they can put themselves in the best position to both come out of COVID (and) also prevent additional spread in the household,” said Associate Professor Noe Crespo, head of the division of health promotion and behavioral science. Some 256 households will be involved, mostly in low-income, heavily Latinx neighborhoods of South San Diego.

“Our strategies are going to be multi-faceted and tailored to their context,” said Crespo, with such characteristics as household size and composition, the level of risk for ventilation, and the protective resources that are available all taken into consideration. Each household will be followed for six months, but  researchers will check for any spread of COVID-19 at the six-week mark.

A core strategy will be motivational interviewing by community health workers from Family Health Centers, “to get them to understand what needs to be done, to take action such as wearing PPE, isolating or keeping social distancing when possible,” Crespo said. This approach will be tested in half the households while the other half receives more standard care as a control group.

This is intended to help uninfected family members understand what needs to be done to stay healthy, Crespo said. Additional strategies could include sending periodic text messages with tips for the subjects to create a “feedback loop” with the health workers.

Crespo said the project could provide an evidence base on how to prevent COVID-19 from spreading in household settings.

Spreading the Word on Vaccines

Additionally, "Communities Fighting COVID! with Vaccines," an effort to support and empower local trusted voices within communities to help encourage and increase vaccinations in underserved communities, has been awarded a $1 million one-year grant through the Health Resources and Services Administration.

“Communities Fighting COVID! with Vaccines” will employ 10 community health workers who will connect with community members over the phone, in person, at businesses and houses of worship and other events. The community health workers will identify the psychological and logistical barriers to vaccination that exist among marginalized communities in San Diego County and help to overcome them.

“Many community members that we call hesitant just haven't had the opportunity to talk about the vaccines with an expert,” said Corinne McDaniels-Davidson, principal investigator on the project. “It is our belief that every person deserves to have their concerns addressed and questions answered, and our CHWs will be equipped to do that in a language concordant and culturally appropriate way.”

The community health workers will be educated on all aspects of the vaccines in an effort to help address the spread of misinformation. They will also be trained for one-on-one conversations to determine individual barriers and connect people to resources. Additionally, community health workers will help arrange child care and transportation when needed, host vaccination pop-up events, create and promote social media content and host opportunity drawings as incentives for those who get vaccinated through the program.