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221 Factors Influencing COVID-19 Testing among American Indians and Latinos in Two Rural Agricultural Communities: A Qualitative Study

Published online by Cambridge University Press:  24 April 2023

Dillon van Rensburg
University of Washington, Institute of Translational Health Sciences, Seattle, WA
Georgina Perez
University of Washington, Institute of Translational Health Sciences, Seattle, WA
Alex Adams
Montana State University, Center for American Indian and Rural Health Equity, Bozeman, MT
Teresa Warne
Montana State University, Department of Health and Human Development, Bozeman, MT
Thomas Quigley
Fred Hutchinson Cancer Research Center, Collaborative Data Services, Seattle, WA
Lorenzo Garza
Sunnyside School District, Family and Community Engagement, Sunnyside, WA
Virgil Dupuis
Salish Kootenai College, Extension Office, Pablo, MT
Paul K Drain
University of Washington, Department of Global Health, Seattle, WA
Linda K Ko
University of Washington, Health Systems and Population Health, Seattle, WA
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OBJECTIVES/GOALS: Despite efforts to improve COVID-19 health outcomes through testing and vaccination, SARS-CoV-2 has exacerbated health disparities in underserved populations. Through this study we examined socio-contextual factors impacting decisions to test for COVID-19 among Native Americans in the Flathead Reservation and Hispanics in the Yakima Valley. METHODS/STUDY POPULATION: A series of 28 key informant interviews and 6 focus groups (N=39 focus group participants) were completed with community and tribal leaders using an interview guide informed by the Theory of Planned Behavior, Social Cognitive Theory, and the Social Contextual Factor Frameworks. The interview guide was designed to examine the socio-contextual factors impacting decisions to test for COVID-19 among Native Americans and Hispanics in the Northwest. A codebook was developed to apply deductive coding to informant responses, followed by an inductive, constant comparison approach. Three analysts met to refine the codebook and conduct inter-rater agreement. RESULTS/ANTICIPATED RESULTS: Five themes (social, cultural, health, religious and political factors) were identified that impacted testing for COVID-19. For social factors, participants discussed the influence of families and friends and unfair employment practices influencing decisions to test. Cultural factors included deep rooted distrust for the government and historical trauma. Health factors participants reported included the importance of testing to save lives, distrust for medical system, and health communications around COVID-19 affecting decisions to test. There was some interaction between religious and political factors. While participants mentioned beliefs in putting things in God’s hands, some decisions to test seemed to be affected by their political views. DISCUSSION/SIGNIFICANCE: Several socio-cultural factors influence decisions to test for COVID-19. Understanding the community’s perception of COVID-19 testing is critical for successful implementation of preventive strategies.

Health Equity and Community Engagement
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Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
© The Author(s), 2023. The Association for Clinical and Translational Science