COVID-19 testing and vaccination uptake among Spanish-speaking Latine persons: impact of a novel social network intervention

BACKGROUND: COVID-19 disproportionately affected Latine communities in the United States, particularly Spanish-speaking and immigrant Latines. Our community-based participatory research (CBPR) partnership developed and tested Nuestra Comunidad Saludable, a Spanish-language intervention harnessing community-based peer navigation and mHealth. The objective of this work is to test the intervention using a cluster randomized trial design to increase COVID-19 testing and vaccination among Spanish-speaking Latino communities in the United States. METHODS: We used a longitudinal, two-group randomized controlled trial design to evaluate the intervention. We recruited 20 peer navigators (Navegantes), each with -eight non-overlapping social network members, and randomly assigned them with their social networks to either the intervention or delayed-intervention group (10 Navegantes and 80 social network members per group) for a total of 160 social network participants at baseline. Data were collected from social network member participants at baseline and immediately post-intervention (six months after intervention-group Navegante training). Participant retention rate was 98.1%. Regression modeling was used to assess changes in testing and vaccination outcomes and intervention-related psychosocial determinants between baseline and follow-up. RESULTS: Mean age of participants was 42 years (SD = 12.8); 77% identified as cisgender women; 85% spoke only or more Spanish than English; and 44% had beyond high school/GED equivalent educational attainment. At follow-up, there were no significant increases in ever having been tested or ever having been vaccinated. Both intervention and delayed-intervention groups experienced improvements in being up to date on recommended vaccine doses and in the number of doses received. Intervention participants reported improvements in some intervention-related psychosocial determinants such as increased testing intention (p