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RADx-UP: Bringing COVID Testing to our Rural Communities

March 30, 2022 by Ellen Brennan

Over the past two years, we’ve heard a lot about quarantines and vaccinations, but there’s a critical aspect of the pandemic response that doesn’t get its equal share of the spotlight: testing. To address this, the National Institutes of Health (NIH) launched the RADx program to support research that expands testing accessibility, and Drs. Adam Atherly of the University of Vermont and Yvonne Jonk of the University of Southern Maine were recently awarded RADx-UP funding to pursue their collaborative project on expanding testing access in our rural areas.

Over the past two years, we’ve heard a lot about quarantines and vaccinations, but there’s a critical aspect of the pandemic response that doesn’t get its equal share of the spotlight: testing. To address this, the National Institutes of Health (NIH) launched the RADx program to support research that expands testing accessibility.

“Rapid response. That’s what they [NIH] wanted; something fast regarding testing and any barriers to COVID testing.” ~ Yvonne Jonk

Since its launch in 2020, around 100 RADx projects across the country have been funded, including the development of different types of COVID test kits. More recently, our NNE-CTR members have received funding through this program for multiple projects focused not only on effective testing protocols, but how to get those tests to the underserved and vulnerable populations unique to our region.


Drs. Adam Atherly of the University of Vermont and Yvonne Jonk of the University of Southern Maine were recently awarded RADx-UP funding to pursue their collaborative project on expanding testing access in our rural areas. “What we’re trying to do is understand barriers to testing,” says Adam, “and the real focus for RADx-UP is vulnerable communities. This is a RADx-UP project, and the ‘UP’ stands for ‘underserved populations.’”

Of course, serving these rural populations requires knowledge of the communities themselves, so the first step is to learn what the barriers people face really are. Collaborating closely with the state Departments of Health for both Maine and Vermont, Adam and Yvonne are forming a partnership with rural communities to work together to pinpoint these barriers.

“There might be some cultural differences between urban and rural areas in terms of where people get information about testing, and how valid that information is… We need to understand the perceptions of the efficacy and safety of getting tested, and then we need to know how accessible those tests are in rural areas. Typically, travel barriers are a big deal. Missing work to even get the test is also a big deal, and these are only a few examples.” ~ Yvonne

Throughout the pandemic, Vermont and Maine have had different approaches to testing, and Adam and Yvonne plan to examine the two and see how these approaches influenced whether people got tested, as well as who was getting tested. With the barriers identified and these two systems to compare, they can then begin to identify exactly what policies need to change to expand testing accessibility for rural areas.

“We can think about individual level factors: my individual risk, income, insurance coverage. We can think about community level factors: whether people can take time off work, distance to testing locations, languages. Then we have the structural factors in terms of how the state is providing testing. So the question is how much of what’s going on can we explain through those different levels? And which ones do we focus on to improve testing in the future?” ~ Adam

The next step, then, is to change testing procedures and assess whether these changes effectively address those barriers. Using testing and population data, Adam and Yvonne can statistically measure how much testing behavior changes by, say, moving testing centers closer or communicating testing messages via locally trusted sources. The final step is to make sure that policy or testing changes align with the needs of our rural communities. “You need to make sure the advice you’re giving is something that’s actually actionable by the people in their lives,” says Adam.

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