Mobilizing community-driven public health response: increasing access to diagnostic testing for underserved and uninsured individuals in Connecticut through lab-in-a-van partnerships

BackgroundPartnering with community leaders, we sought to address ongoing diagnostic testing needs in underserved neighborhoods and evaluate whether a saliva-based mobile testing program could help overcome barriers to testing for uninsured and low-income individuals. This is critical as many lack a primary care provider, cannot access reliable health information, or have limited financial resources. MethodsFree saliva-based, SARS-CoV-2 diagnostic testing was offered at 123 local community events in Connecticut, between June 2023 to July 2024. The SalivaDirect extraction-free RT-qPCR protocol was run on a CLIA licensed van operated by Yale Pathology Labs under FDA Emergency Use Authorization. Testing locations were identified and advertised in partnership with the community. Patient perspectives on approachability, convenience, and usefulness of mobile testing were recorded via REDcap. ResultsApproximately 100 local contacts informed the mobile testing model. Overall, 1,428 individuals participated, with 838 completing a testing experience survey. Of these, 54% identified as Black, Indigenous, People of Color; 59% reported annual household income less than $25,000; 31% were uninsured. Test results were reported in an average 3.1 hours, 48 positive samples were identified. Test takers agreed it was easy to access the van (74%) and felt comfortable (75%); 29% received their first COVID-19 test at the van; 48% were unaware of alternate testing; 44% reported difficulty accessing health care; and 49% identified transportation as a challenge. ConclusionsThis study demonstrated the positive impact mobile testing could have for overcoming barriers to accessing healthcare, and its potential to serve as a framework for managing and responding to future public health needs.