Document text
Principal Investigator: Robert H Tukey
Organization: UNIVERSITY OF CALIFORNIA, SAN DIEGO
Fiscal Year: 2020
Award: $3,759,967
Funding agency: National Institute of Environmental Health Sciences
ABSTRACT
San Ysidro sits on the US-Mexico border and has a linguistically and ethnically diverse (91% Latinx) population,
which is impacted by significant economic and health disparities. 33% of household incomes are less than
$29K/yr, and there is a high rate of the comorbidities linked to poor COVID-19 outcomes. The San Ysidro Port
of Entry is one of the largest international border crossing facilities in the world, with an estimated 50,000 vehicles
and 25,000 pedestrians crossing into the US each day. A young and culturally diverse community of 27K
residents, San Ysidro has the largest number of pre- and middle school children in San Diego. Physically
removed from the major testing centers in San Diego, the response to the pandemic in San Ysidro has been
hampered by a shortage of COVID-19 testing coupled with long test result turnaround times. The San Ysidro
community has been disproportionately impacted by COVID-19, with the highest incidence of COVID-19 cases
in San Diego County. Although children with COVID-19 infection generally have good outcomes, closures of
public schools and associated activities have deprived many children of important educational and nutritional
resources. Fear of infection has resulted in marked drops in prenatal and pediatric visits and lower childhood
immunization rates. Since regular prenatal and pediatric care is associated with optimal pregnancy and child
health outcomes, ensuring the safety of clinics is a high priority. San Ysidro Health is a federally qualified health
center and the largest healthcare delivery system serving San Ysidro residents, including the uninsured and
underinsured. The recommended schedule of prenatal and pediatric visits (for surveillance of maternal and fetal
well-being, monitoring of childhood development, and provision of immunizations) provides an excellent
opportunity to engage families in COVID-19 testing within an otherwise hard-to-reach population. At UC San
Diego, scientists and engineers have developed a new high-throughput FDA authorized robotic testing workflow
that provides an inexpensive, accurate, and rapid detection of COVID-19 infections. As part of the UC San Diego
Superfund Research Center (SRC), we have in place extensive Community Outreach and Engagement with
several South San Diego regions and have established strong partnerships with these communities, including
those at San Ysidro. We will rely on a mixed methods, multi-level community-engaged approach to gather
information on the barriers and facilitators of the delivery and uptake of COVID-19 testing at the individual,
organizational and community levels. In partnership with our diverse Community and Scientific Advisory Board,
we will use co-creation and appreciative inquiry approaches to inform the development, implementation and
evaluation of a set of contextually relevant strategies that will accelerate the broad delivery and uptake of COVID-
19 testing among pregnant women and children and scaling across the entire San Ysidro community. The
overarching goal of extensive and rapid COVID-19 testing is to eliminate the disparities experienced by
underserved communities in testing access and ultimately in morbidity and mortality from COVID-19.
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