A Faithful Response to COVID-19 Project

The primary aim of this study is to conduct a two-arm clustered randomized controlled trial
to fully test a multilevel, religiously-tailored African American church-based COVID19
testing and linkage to care (LTC) intervention (Tx) vs a nontailored multilevel,
attention-control (AC) condition on COVID19 testing uptake (primary outcome) at 6 mos. LTC,
contact tracing approval (CTA) and prevention behaviors (exploratory secondary outcomes) will
also be examined with participants, adult African American church and community members.
Churches will be matched on attendance size and denomination, and randomly assigned to Tx or
AC. Previous HIV testing and diabetes prevention studies conducted in African American
churches, whereby the Theory of Planned Behavior (TPB) and Socioecological Model will guide
intervention design and delivery, will be adapted for this project. Using a community engaged
approach, these models provide a theoretically-based, ecologically-expanded TBP framework for
intervention delivery through multilevel church outlets to increase reach, dose, and impact.
Sixteen churches (45 church members and 15 community members using outreach services per
church; N= 960 total) have been project to be required to detect significant increases in
testing.

Trained church health workers will deliver the Tx intervention during existing, multilevel
church activities using a culturally-tailored COVID19 Tool Kit inclusive of digital tools
consisting of: a) individual self-help materials and automated/tailored text messages; b)
virtual supportive group seminars about COVID19; c) virtual/in-person church services with
COVID19 related materials/activities (e.g., sermons, pastors modeling testing, testimonials,
bulletins); and d) church-community level COVID19 testing and LTC services (e.g., healthcare,
prevention programs, community resources, contact tracing) provided virtually by community
health workers. All churches will host COVID19 testing events. First, a pilot study site will
be used to test project feasibility followed by the 16 RCT faith-based study sites. Social,
ethical, behavioral implications (SEBI) data will also be collected. All data will be made
available to the Rapid Acceleration of Diagnostics Underserved Populations (RADxUP) Data
Consortium.

Specific Aims (SA):

SA 1. Test a tailored TPB-guided multilevel, COVID19 intervention against a nontailored AC
arm on uptake of COVID19 testing, and LTC/CTA & prevention behaviors with African American
church-populations at 6 months.

Hypothesis: The tailored, TPB testing/LTC intervention will attain higher testing rates than
AC at 6 months.

SA 2. Evaluate roles of potential mediators and moderators related to COVID19 testing among
church-affiliated African Americans at 6 months to determine modifiable
facilitators/barriers.

SA 3. Conduct a process evaluation to understand study implementation facilitators, barriers,
and fidelity; and examine relationships between implementation, intervention dose and
exposure, and intervention outcomes to identify and improve essential intervention
components.

Significance: This novel study is the first to fully test a COVID19 testing and LTC
intervention in African American churches. It could provide a theory-based, multilevel model
for delivering scalable, wide-reaching COVID19 testing and LTC by supporting African American
faith leaders with culturally-appropriate, easy-to-use tools and health agency partnerships.
It could have a major impact on uptake of COVID19 testing, inform on LTC and contact tracing,
and streamline future vaccine delivery in African American communities hard hit by COVID19.