ABSTRACT
Background. The Baltimore City Health Department (BCHD) began community-based COVID-19 testing in response to the pandemic on April 21, 2020. The purpose was to provide access to COVID-19 testing to underserved communities. BCHD designed the program to accommodate transportation limitations, limited-access to internet and phones, and non-English speakers. BCHD has continued hosting up to five community-based testing sites per week. This analysis examines the test results of BCHD's COVID-19 community-based testing program to date. Methods. Patients completed an intake form, which included demographic information, at the testing event, prior to providing their specimen for COVID-19 testing. For this analysis, patient demographics and test results were analyzed using REDCap software. Results. Total test volume for year 2020 (4/21/2020 -12/30/2020) was 15,839, year 2021 (1/5/2021- 12/30/2021) was 13,087, and year 2022 (1/4/2022 - 4/1/2022) was 2,261. Average percent positivity for year 2020 was 9%, year 2021 was 7%, and year 2022 to date was 6%. Patient ethnicity was Non-Hispanic 85.5%, Hispanic 13.5%, and Did not respond/Don't know 1.0%. Race was Black or African America 61.1%, White 25.0%, Asian 2.8%, American Indian/Alaska Native 0.1%, Native Hawaiian or Other Pacific Islander 0.1%, and Unknown 10.7%. Total positive COVID-19 results among Black/African Americans in 2020, 2021, and 2022 respectively were 1567 (12.8%), 1177 (15.1%), and 218 (22.1%). Total positive COVID-19 results among White in 2020, 2021, and 2022 respectively were 541 (10.1%), 441 (12.1%), and 60 (15.1%) respectively. Total positive COVID-19 results among Asians in 2020, 2021, and 2022 were 63 (20.9%), 47 (11.0%), and 4 (25.5%) respectively. Total positive COVID-19 results among Native Hawaiian or Other Pacific Islander in 2020, 2021, and 2022 respectively were 4 (16.7%), 4 (20.0%), and 2 (0.0%) respectively. Total positive COVID-19 results among American Indian/Alaskan in 2020, 2021, and 2022 were 3 (13.6%), 1 (7.1%), and 2 (66.7%) respectively. Conclusion. BCHD's community-based testing program has completed over 31,000 tests to date. COVID-19 percent positivity among patients showed a decline across the three years. This analysis demonstrates how a local health department can provide testing to the communities.
ABSTRACT
Background: Overseas Filipino workers (OFWs) is one of the largest communities of international migrant workers. They face systemic barriers to fulfilling their health needs. The COVID-19 pandemic worsened this condition and provided a context to evaluate the utility of a digital mental health intervention delivered within a stepped-care model to address OFW mental health. Using an implementation science framework, this study aimed to evaluate stakeholders' perspectives on the implementation of Kumusta Kabayan, a mobile phone-based mental health app, for OFWs in Macao. Methods: A mixed-methods convergent design was used by conducting two parallel steps, including quantitative and qualitative measures. The quantitative data was collected from Filipino team members and local non-governmental organization (NGO) staff members (N = 12). The qualitative data were gathered from interviews with OFWs in Macao who used the app (N = 25; 80% females, 76% domestic workers). Results: From the online survey, the staff members of the local partner NGO and the Filipino team members strongly perceived that their organization could adapt Kumusta Kabayan to their program and generally evaluated that Kumusta Kabayan achieved its goal and was received well by OFWs. In the interviews, the OFW app users shared their experiences in using Kumusta Kabayan, which was thematically organized into six aspects of the participants' experience: (1) promotional channel and expectation; (2) when to use the app and in what language; (3) lessons learnt; (4) memorable aspects; (5) key facilitators and barriers; and (6) suggestions. Conclusion: Kumusta Kabayan was well accepted and shows potential to be integrated into the existing support services for OFWs in Macao. This app has the promise of being scaled-up for OFWs in other countries by collaborating with local and overseas stakeholders. Lessons learnt from this evaluation could also be implemented in wider digital mental health services in different settings.