A Community-Adapted Approach to SARS-CoV-2 Testing for Medically Underserved Populations, Rhode Island, USA

Matthew Murphy; Imshan Dhrolia; Alexandra Zanowick-Marr; Jun Tao; Cassie Sutten Coats; Siena Napoleon; Yelena Malyuta; Emily Adams; Trisha Arnold; Philip A. Chan; Amy Nunn


Emerging Infectious Diseases. 2021;27(9):2445-2449. 

In This Article

Abstract and Introduction


We developed a testing program for severe acute respiratory syndrome coronavirus 2 in an urban Latinx neighborhood in Providence, Rhode Island, USA. Approximately 11% of Latinx participants (n = 180) tested positive. Culturally tailored, community-based programs that reduce barriers to testing help identify persons at highest risk for coronavirus disease.


As of May 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had infected >154 million globally and caused >3.2 million deaths.[1] The United States accounts for ≈21% of coronavirus disease (COVID-19) cases and related deaths worldwide.[1] Vaccines are a highly effective transmission prevention tool. However, SARS-CoV-2 testing, contact tracing, and quarantining are among the few effective prevention measures available to the public that are proven to reduce transmission in the setting of variable vaccine availability and uptake.[2] The COVID-19 disease burden has disproportionately affected Black and Latinx populations in the United States.[3,4] These health disparities in racial and ethnic minority populations are driven by complex social and structural factors, such as a paucity of health services, absence of culturally tailored services, and economic barriers that affect adherence to quarantine guidelines.[5,6] These disparities have been further compounded by fragmented SARS-CoV-2 testing policies in the United States, which have not prioritized testing for medically underserved racial and ethnic minority communities.[2]

Rhode Island experienced high rates of SARS-CoV-2 infection early in the pandemic and has been recognized for expanding testing early across the state.[5] Policies in Rhode Island evolved in tandem with the pandemic and availability of testing supplies. In April 2020, faced with limited testing supplies and healthcare personnel, officials in Rhode Island restricted SARS-CoV-2 testing to prescheduled appointments for symptomatic persons with recent travel histories.[7,8] By June, testing recommendations in Rhode Island had evolved to include populations considered at high risk for COVID-19, and the state has since maintained one of the highest per capita testing rates in the United States.[7,8] However, most testing locations required appointments and were limited to symptomatic patients, and services were not offered in most urban communities, where infection rates were highest.

As seen elsewhere in the United States, the Latinx community in Rhode Island has been disproportionately affected by COVID-19.[9] The Latinx community constitutes just 14% of the population in Rhode Island; the most represented countries and territories are Mexico (35%), Cuba (29%), Spain (11.7%), and Puerto Rico (8.9%). However, the Latinx community accounts for 38% of positive SARS-CoV-2 tests and 33% of COVID-19–related hospitalizations in the state.[1,8]