COVID-19 Testing and Vaccination Social Network Diffusion for Diverse Criminal Legal Involved Communities

Background: The purpose of this study was to increase appropriate COVID-19 testing and vaccination among Criminal Legal Involved (CLI) communities. These communities included non-incarcerated individuals with recent arrests, incarceration, probation, parole, or diversion program involvement. Many had limited testing histories and vaccine hesitancy. Materials/Methods: The intervention used a social network diffusion model supported by motivational interviewing to mobilize participants. The study was implemented at four sites in Baton Rouge, Little Rock, Indianapolis, and Chicago. Existing community engagement structures were used to ensure full integration of local partners, and the RE-AIM framework guided implementation. A randomized controlled trial tested the efficacy of the intervention compared with an existing linkage-to-care intervention among primary participants and their network contacts. Outcome/Impact: The study generated evidence on how social network diffusion can increase situation appropriate COVID-19 testing and vaccination among CLI communities. The findings provided insight into individual and network factors that supported uptake and informed approaches for scalable community-integrated prevention strategies.