# Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted Interventions

> **NIH NIH U54** · MAINEHEALTH · 2021 · $940,910

## Abstract

The COVID-19 pandemic has disproportionately affected people from vulnerable and disadvantaged
communities. Research to date has highlighted the factors that contribute to these disparities including
differential treatment and experience of marginalized populations in healthcare and research settings, reduced
access to testing and care, living in congregate or multigenerational households, the economic consequences
of being diagnosed with COVID-19 and quarantining, differing understanding of and attitudes towards the
pandemic, and concerns about contact tracing. Immigrant and low income populations, and people
experiencing homelessness, many with mental illnesses, and/or have been recently incarcerated, are hesitant
to participate in testing and to accept COVID-19 testing and vaccination. There is an urgent need to
understand how to deliver information about testing and vaccination that is understandable and resonates with
higher risk communities in their cultural and social contexts. Effective public health strategies for delivering this
information must include community input and partnerships. Working closely with community partners who
have insight into cultural, behavioral, economic, and factors impacting people’s decision making about testing
and vaccine acceptance is essential to developing effective communication and outreach strategies for
engaging individuals in testing, vaccination, and care. Working with our community partners, we will create and
evaluate the impact of a public health intervention in the area of Cumberland County, Maine, to provide
outreach, testing, and vaccination education to a large community of immigrants from sub-Saharan Africa, the
Middle East, and Central America, higher-risk low-income people accessing a public health facility (with a
sexually transmitted infections clinic, needle exchange, and a free clinic), and individuals experiencing
homelessness. This will be a longitudinal study to understand beliefs about and knowledge of COVID-19, and
barriers and beliefs about testing and vaccination. Results will inform a community-developed and based
intervention to engage the cohort and other members of these populations in testing and vaccine education,
and evaluate the impact of this intervention on testing and vaccination uptake in our immigrant, low-income,
and homeless communities. Specific Aims: 1) To understand patient perceptions of, fears about, and
experiences with COVID-19 testing and vaccination, including booster vaccination in our immigrant, low-
income, and homeless populations. 2) To use the data from Aim 1 to develop and pilot test a public health
messaging and testing program to increase vaccine and testing uptake in our populations of interest. 3) To
evaluate the impact of a public health messaging and testing program developed in Aim 2 on rapid COVID-19
testing and vaccine uptake. While it will need to be adapted based on local communities’ cultures and needs,
this work could be foundational f...

## Key facts

- **NIH application ID:** 10413438
- **Project number:** 3U54GM115516-05S2
- **Recipient organization:** MAINEHEALTH
- **Principal Investigator:** CLIFFORD JAMES ROSEN
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $940,910
- **Award type:** 3
- **Project period:** 2021-09-07 → 2022-08-04

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413438

## Citation

> US National Institutes of Health, RePORTER application 10413438, Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted Interventions (3U54GM115516-05S2). Retrieved via AI Analytics 2026-06-08 from https://api.ai-analytics.org/grant/nih/10413438. Licensed CC0.

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