Early in the pandemic it became clear certain groups suffered more from COVID-19, the disease caused by the novel coronavirus SARS-CoV-2. In particular, African Americans, Hispanics/Latinos and Native Americans not only were diagnosed with COVID-19 in disproportionate numbers, but also were more likely to suffer serious health consequences or die from the disease. Their populations account for more than half of all reported U.S. cases, which now have surpassed 8 million.
Sairam Parthasarathy, MD, chief of the UArizona Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, leads the Arizona effort to reduce disparities in underrepresented communities in COVID-19 research and clinical trials. (Photo: University of Arizona Health Sciences, Kris Hanning)Sairam Parthasarathy, MD, chief of the UArizona Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, leads the Arizona effort to reduce disparities in underrepresented communities in COVID-19 research and clinical trials. (Photo: University of Arizona Health Sciences, Kris Hanning)
In response, the National Institutes of Health, as part of an 11-state effort to address such health disparities, has awarded $12 million for outreach and engagement efforts in ethnic and racial minority communities disproportionately affected by COVID-19. This 11-state alliance created by the NIH is called the Community Engagement Alliance Against COVID-19 Disparities, or CEAL. Teams in Alabama, Arizona, California, Florida, Georgia, Louisiana, Michigan, Mississippi, North Carolina, Tennessee and Texas have received initial funding to create CEAL programs immediately.
“It was clear to us early in the pandemic the University of Arizona needed to reach out and assist communities across the state to help understand and fight COVID-19,” said University of Arizona President Robert C. Robbins, MD. “With this support from the NIH, we will be able to work closely with Arizona’s other public universities and other partners to look at why specific populations in the United States are suffering at a much greater rate from COVID-19. It also builds on a recent commitment by the Tohono O’odham Nation to give $1 million toward efforts to accelerate the work of University of Arizona researchers to create new and more efficient, effective and affordable COVID-19 tests.”
In Arizona, the CEAL program is being led by Sairam Parthasarathy, MD, the program’s lead principal investigator and chief of the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine in the UArizona College of Medicine – Tucson. Co-investigators for the UArizona Health Sciences effort include: Tracy Crane, PhD; Daniel Derksen, MD; Kacey Ernst, PhD, MPH; Fayez Ghishan, MD; Nirav Merchant and Francisco Moreno, MD.
“This collaborative effort, which seeks to help ease the burden on some of Arizona’s most vulnerable populations, also will increase their participation in the development of vaccines and clinical therapies to fight this dreadful disease,” said Michael D. Dake, MD, UArizona Health Sciences senior vice president. “The Arizona team’s collaborative outreach efforts can only make these potential remedies more effective in addressing the disparate health impact of COVID-19.”
Tracy Crane, PhD, RD, a UArizona assistant professor of nursing and public health and co-director, Behavioral Measurement and Interventions Shared Resource for the Cancer Prevention and Control Program, UArizona Cancer CenterTracy Crane, PhD, RD, a UArizona assistant professor of nursing and public health and co-director, Behavioral Measurement and Interventions Shared Resource for the Cancer Prevention and Control Program, UArizona Cancer Center
Splitting a $1 million, one-year subcontract award, the UArizona Health Sciences team – along with researchers from Arizona State University, Northern Arizona University and Mayo Clinic in Scottsdale – have formed the Arizona CEAL COVID Consortium, or AC3. As AC3 co-principal investigators, Sabrina Oesterle, PhD, leads the ASU effort, Samantha Sabo, DrPH, leads the NAU effort, Chyke Abadama Doubeni, MD, leads the Mayo Clinic effort and Floribella Redondo Martinez heads up the effort by the Arizona Community Health Workers Association. Their overarching goal is to conduct community-engaged research and outreach to increase COVID-19 awareness and education among communities disproportionately affected by COVID-19 and to reduce misinformation and mistrust.
“Community engagement is the cornerstone for performing highly relevant and impactful health disparities research,” Dr. Parthasarathy said. “ASU, Mayo, NAU and University of Arizona investigators under AC3 will work closely with community advisers to identify urgent unmet needs and rapidly develop and tailor existing infrastructures, such as AZCOVIDTXT, and a diverse workforce of community health workers.”
The AZCOVIDTXT initiative, which allows volunteers to relay household health information anonymously via a two-way text messaging service, was created this past spring by a team of UArizona researchers to better track COVID-19 and gather and disseminate information about available resources for those affected.
“With the AC3 CEAL initiative,” Dr. Crane said, “we will be able to better understand the needs of our underrepresented – or, in this case, overrepresented – communities to meet their needs via tailoring of AZCOVIDTXT, as well as utilizing community health workers through a toll-free health number that will link directly to the community health workers so people who don’t have a smart cellphone can receive the same help and information.”
The initiative also will involve mobile health units, such as those deployed in the Phoenix and Tucson areas by the UArizona Mel and Enid Zuckerman College of Public Health in outreach to Spanish-speaking communities, as well as additional outreach to rural and Native American communities throughout the state.
This multiprong approach, Dr. Parthasarathy said, aims to establish effective, culturally appropriate strategies to enhance participation of communities disproportionally affected by COVID-19 in research designed to advance the prevention and treatment of COVID-19 and reduce the burden of disease on the hardest-hit communities. They will do that, in part, by leveraging existing relationships with more than 30 Arizona community-based organizations and partners. These steps aim to help community organizations address misinformation, build trust and broaden awareness to reduce the overall impact of COVID-19. A key focus will be to promote and facilitate inclusion and participation of these ethnic and racial groups in vaccine and therapeutic clinical trials to prevent and treat the disease.
They also will promote nationally developed information resources and a clinical trial patient registry. Dr. Parthasarathy pointed out that even though half of all COVID-19 cases are among minority/ethnic groups, only a small proportion of participants who signed up for clinical trials are from these underrepresented communities. You can follow the AC3 initiative via Twitter here.
“One of our tasks,” Dr. Parthasarathy said, “is to enable greater awareness for coronavirus information available at the coronaviruspreventionnetwork.org website, which is the NIH COVID-19 Prevention Network that is orchestrating these clinical research studies related to vaccines and other therapeutic remedies. The site not only disseminates educational material and resources in multiple languages, but also establishes a COVID-19 volunteer registry for potential research participants.”
About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually.