UC BRAID Funding for COVID-19 Health Equity Projects
October 14, 2021
In September 2020, UC Biomedical Research Acceleration, Innovation and Development (UC BRAID) launched the Addressing Health Equity in COVID Research initiative which provided $100K in support to each of the 5 UC Clinical and Translational Science Award (CTSA) campuses to enhance existing research projects and enable increased inclusion. The initiative was a mechanism to immediately provide support to existing project (e.g. clinical trials, social/behavioral, and community engagement research) and address the intersecting challenges of COVID-19 and health disparity.
The Clinical and Translational Science Center (CTSC) has longstanding programs to engage underserved communities to mitigate the inequities that underlie these disparities, including the low rates of participation in research. The CTSC invested the BRAID initiative funds in our program to further broaden participation of traditionally under-represented groups, and especially the Latinx, Black and Native American communities of the California Central Valley and North Valley and low income, urban populations that have been disproportionately affected by COVID-19.
• Community engagement activities used funding to increase COVID-19 testing numbers, providing compensation to survey participants, and hiring an expert to pilot test cognitive interviews and improve core data collection instruments for the RADx-UP funded ORALE COVID-19 project.
• Special populations consisting of Asian, immigrant, and refugee communities of South Sacramento, were supported by the local purchase and provision of culturally appropriate nutrition support to over 150 families weekly, sustaining both families and locally owned small businesses at the height of the pandemic.
• In a local low-income, historically Black community classed as a “food desert” and underserved by public transit, the CTSC established a synergistic relationship between youth training programs in nutrition and food preparation and small farm suppliers, to safely deliver produce and coordinated virtual instruction in healthy meal preparation incorporating fresh, seasonal fruits and vegetables.
Institute for Clinical and Translational Science (ICTS) used the resources to expand its reach and inclusion for COVID-19 clinical trials for diverse and often underserved populations in Orange County and neighboring regions. We built on our existing consortium of community hospitals to ensure robust recruitment of the large Latino community in central Orange County, currently experiencing a surge in COVID-19, and the Vietnamese-American community (the largest concentration outside of Vietnam itself). We also enhanced our partnership with African-American communities and in neighboring Long Beach through our existing collaboration with the Long Beach VA and the MemorialCare Health System.
• The ICTS formed focus groups of Hispanic, low-income parents and children to learn about attitudes regarding pediatric vaccines.
• A second group focused on vaccine responsiveness among vulnerable populations such as elderly and Latinx individuals.
• The third group is to focus on veterans through our outreach to the UCI Affiliated Tibor Rubin Long Beach VA
UC Los Angeles
The mission of the UCLA Clinical and Translational Science Institute (CTSI) is to translate discoveries to improve health in Los Angeles, especially among the underserved. As we continue to build trust in our diverse community, the additional resources were used to support accrual to clinical trials as well as research to understand attitudes toward a vaccine and factors that influence disease spread. Projects include:
• The UCLA CTSI-led Community Engagement Alliance Against COVID-19 Disparities (CEAL) Award is a coalition of 11 academic institutions and their community partners for a statewide community-engaged approach to addressing COVID-19 among communities that have been disproportionately affected. The UCLA CTSI is coordinating the STOP COVID-19 CA (Share, Trust, Organize, Partner: The COVID-19 California Alliance) alongside 70 community-based organizations to reduce structural barriers to vaccine registration and facilitate vaccination through on-the-ground community outreach in low-socioeconomic communities with low vaccination rates, and monitor trends in vaccine hesitancy via research surveys.
• RADx-UP Social, Ethical, and Behavioral Implications (SEBI) Initiative. Funded under NIH’s Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) initiative SEBI, this project, called “A Community Health Worker Intervention to Identify and Decrease Barriers to Pre-Procedural COVID-19 Testing among Los Angeles County Department of Health Safety-Net Patients,” is led by UCLA CTSI partner site Charles Drew University and is a supplement to an existing R01.
• The UCLA CTSI partnered with the Governor’s Office of Government Operations for the California Get Out the Vaccine (GOTV) campaign, to contract 34 community organizations in the Central Valley and Los Angeles County for door-to-door canvassing for COVID-19 vaccination and social services linkages (rental assistance, food assistance programs and other COVID-19 recovery programs).
UC San Diego
The Altman Clinical and Translational Research Institute (ACTRI) is committed to improving access to medical care in San Diego County as well as Imperial County, an underserved area in Southern California. Through the UC BRAID grant, ACTRI supported the following projects:
• The Refugee Health Unit served as an information source for refugee communities, surveying their experience and needs during the pandemic and providing information and resources in 12 languages to address vaccine hesitancy. They also coordinated with UC San Diego Health’s mobile vaccine unit to deliver vaccines directly to these communities. The mobile unit also vaccinated thousands of cross-border workers in partnership with the Consulate General of Mexico.
• In collaboration with El Centro Regional Medical Center, the building of clinical trial infrastructure and capacity to enable future vaccine and novel COVID-19 therapies and non-COVID research in the region. Work included creation of a research footprint, including space to recruit participants and administer investigational drugs. ACTRI also provided a clinical research coordinator, regulatory expertise and knowledge sharing to successfully launch and perform clinical trials.
• The establishment of the San Diego Advancing Minority Health Literacy Program to address the disproportionate effects of the pandemic on racial and ethnic minorities by enhancing testing, contact tracing and other mitigation measures. A committee of health literacy experts and eight local government partners, including the City of Chula Vista, will identify and implement culturally sensitive strategies in local communities.
UC San Francisco
Clinical and Translational Science Institute (CTSI) used the UC BRAID funding to support elements of two key programs designed to combating systemic barriers to racial inclusivity in COVID-19 research. These programs will serve as models for more general anti-systemic racism efforts in research going forward.
• An institutional Task Force on Equity and Anti-Racism in Research to better inform the institution on structural issues that impact COVID research equity. This Task Force generated recommendations for systematic change, supported and funded an anti-racism pilot research grant mechanism, and leveraged this work to attract other campus partners. The initiative also helped further community-based research projects focused on vulnerable populations and the underserved.
• A community engagement program to enhance participation of community members of color and other key stakeholder groups on the UCSF COVID Patient and Community Advisory Board (PCAB). The board provided consultation to over 20 COVID-19 clinical research projects at UCSF as well to the clinical research enterprise to ensure that health equity and patient/community engagement is a priority . By engaging unrepresented community members, the board had more representative input for diversity, equity and inclusion review of COVID studies. Also, the input from a more diverse board helped researchers understand how to better reach to communities most impacted by COVID-19 and engage populations traditionally underrepresented in clinical research. This program also led to participation in the trans-UC STOP COVID-19 CA effort.