{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:22:52Z","timestamp":1782296572763,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P20GM104417"],"award-info":[{"award-number":["P20GM104417"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Native Americans and Latinos have higher COVID\u201019 infection and mortality rates and may have limited access to diagnostic testing. Home\u2010based testing may improve access to care in rural and underserved populations. This study tests the effect of community health worker (CHW) support on accessibility, feasibility, and completion of COVID\u201019 home testing among Native American and Latino adults living on the Flathead Reservation in Montana and in Yakima Valley, Washington.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A two\u2010arm, multisite, pragmatic randomized controlled trial was conducted using block randomization stratified by site and participant age. Active arm participants received CHW assistance with online COVID\u201019 test kit registration and virtual swabbing support. The passive arm participants received standard\u2010of\u2010care support from the kit vendor. Logistic regression modeled the association between study arm and test completion (primary outcome) and between study arm and test completion with return of valid test results (secondary outcome). Responses to posttest surveys and interviews were summarized using deductive thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Overall, 63% of participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a0268) completed COVID\u201019 tests, and 50% completed tests yielding a valid result. Active arm participants had higher odds of test completion (odds ratio: 1.66, 95% confidence interval [1.01, 2.75]). Differences were most pronounced among adults \u226560\u00a0years. Participants cited ease of use and not having to leave home as positive aspects, and transportation and mailing issues as negative aspects of home\u2010based testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CHW support led to higher COVID\u201019 test completion rates, particularly among older adults. Significant testing barriers included language, educational level, rurality, and test kit issues.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12830","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T06:41:46Z","timestamp":1709793706000},"page":"709-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Critical lessons from a pragmatic randomized trial of home\u2010based COVID\u201019 testing in rural Native American and Latino communities"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1258-0068","authenticated-orcid":false,"given":"Eliza","family":"Webber","sequence":"first","affiliation":[{"name":"Center for American Indian and Rural Health Equity Montana State University  Bozeman Montana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bishop","sequence":"additional","affiliation":[{"name":"Division of 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