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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Nov 10, 2024
Date Accepted: Jul 2, 2025

The final, peer-reviewed published version of this preprint can be found here:

Identifying Optimal Testing Modalities to Increase COVID-19 Testing Access in Baltimore, Maryland: Protocol for a Household Randomized Controlled Trial

Duchen J, Mueller AK, Ahmed S, Perin J, Borsuk C, Trowell J, Lowensen K, Huettner S, Peytchev A, Farley JE, Mehta SH, Jennings JM

Identifying Optimal Testing Modalities to Increase COVID-19 Testing Access in Baltimore, Maryland: Protocol for a Household Randomized Controlled Trial

JMIR Res Protoc 2025;14:e68600

DOI: 10.2196/68600

PMID: 41037805

PMCID: 12531582

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Identifying Optimal Testing Modalities to Increase COVID-19 Testing Access: Protocol for a Household Randomized Control Trial in Baltimore, MD

  • Jessica Duchen; 
  • Alexandra K Mueller; 
  • Saifuddin Ahmed; 
  • Jamie Perin; 
  • Courtney Borsuk; 
  • Joshua Trowell; 
  • Kelly Lowensen; 
  • Steven Huettner; 
  • Andy Peytchev; 
  • Jason E Farley; 
  • Shruti H Mehta; 
  • Jacky M Jennings

ABSTRACT

Background:

The COVID-19 pandemic disproportionately affected low-income, and racial and ethnic minority populations. Testing plays a critical role in disrupting disease transmission, but complex barriers prevent optimal testing access, particularly for Black and Latinx communities. There is limited evidence on optimal testing modalities to increase testing access for these populations.

Objective:

The primary objective of the Community Collaboration to Combat COVID-19 (C-FORWARD) trial is to define optimal COVID-19 testing modalities for maximizing testing acceptance, uptake, and timeliness of results receipt.

Methods:

C-FORWARD is a household-randomized comparative effectiveness trial conducted in an urban population representative sample. Households across 653 census block groups were sampled using a probability proportional to size approach. The primary outcome was the completion of SARS-COV-2/COVID-19 testing within 30 days of randomization.

Results:

Between February 2021 and December 2022. 1,083 individuals (881 index participants and 202 household members) were enrolled. The mean age of participants was 51 (SD ±18) years. Forty-three percent of participants identified as Black or African American, 48.6% as white, and 9.0% as other, including Asian, American Indian, Native Hawaiian or Pacific Islander, and multiple races. Five percent of participants identified as Hispanic or Latino. At the time of enrollment, 51.1% were currently working either full or part-time and 32.9% of participants had an advanced degree. Eighty percent of participants had been tested for COVID-19 previously, with 22.3% reporting having previously tested positive for COVID-19, and 86.8% of participants reported receiving at least one COVID-19 vaccination prior to enrollment.

Conclusions:

Data from the C-FORWARD trial will be used to address important questions regarding COVID-19 testing acceptance and uptake in an urban population. Clinical Trial: Clinical Trials.gov ID: NCT04673292


 Citation

Please cite as:

Duchen J, Mueller AK, Ahmed S, Perin J, Borsuk C, Trowell J, Lowensen K, Huettner S, Peytchev A, Farley JE, Mehta SH, Jennings JM

Identifying Optimal Testing Modalities to Increase COVID-19 Testing Access in Baltimore, Maryland: Protocol for a Household Randomized Controlled Trial

JMIR Res Protoc 2025;14:e68600

DOI: 10.2196/68600

PMID: 41037805

PMCID: 12531582

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