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Abdi N, Ebengho S, Mohamed N, Scallon A, Mohamed A, Ahmed A, Abdi A, Ahmed R, Mohamed F, Ibrahim A, Ali A, West KM, Ronen K. Early Pandemic Access to COVID-19 Testing in the Somali Community in King County, Washington, USA: a Mixed-Methods Evaluation. J Racial Ethn Health Disparities 2023; 10:2930-2943. [PMID: 36478269 PMCID: PMC9734463 DOI: 10.1007/s40615-022-01470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Racial and ethnic disparities in COVID-19 infection and outcomes have been documented, but few studies have examined disparities in access to testing. METHODS We conducted a mixed methods study of access to COVID-19 testing in the Somali immigrant community in King County, Washington, USA, early during the COVID-19 pandemic. In September 2020-February 2021, we conducted quantitative surveys in a convenience sample (n = 528) of individuals who had accessed PCR testing, recruited at King County testing sites near Somali population centers and through social media outreach in the Somali community. We compared self-identified Somali and non-Somali responses using Chi-square and Wilcoxon rank sum tests. We also conducted three Somali-language focus groups (n = 26) by video conference to explore Somali experiences with COVID-19 testing, and in-depth interviews with King County-based policymakers and healthcare workers (n = 13) recruited through the research team's professional network to represent key demographics and roles. Data were analyzed using qualitative rapid analysis to explore the county's COVID-19 testing landscape. RESULTS Among 420 survey respondents who had received COVID-19 testing in the prior 90 days, 29% of 140 Somali vs. 11% of 280 non-Somali respondents tested because of symptoms (p = 0.001), with a trend for longer time from symptom onset to testing (a measure of testing access) among Somali respondents (median 3.0 vs. 2.0 days, p = 0.06). Focus groups revealed barriers to testing, including distrust, misinformation, stigma, language, lack of awareness, and transportation. Stakeholders responding from all sectors highlighted the importance of community partnership to improve access. CONCLUSION Somali communities experience barriers to COVID-19 testing, as evidenced by the longer time from symptom onset to testing and corroborated by our qualitative findings. These barriers, both structural and community-derived, may be overcome through partnerships between government and community to support community-led, multilingual service delivery and racial representation among medical staff.
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Affiliation(s)
- Najma Abdi
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Sabrina Ebengho
- School of Public Health, University of Washington, Seattle, WA, USA
- Somali Health Board, Tukwila, WA, USA
| | | | - Andrea Scallon
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Ayan Mohamed
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Asiya Ahmed
- School of Public Health, University of Washington, Seattle, WA, USA
- Somali Health Board, Tukwila, WA, USA
| | | | - Ruweida Ahmed
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Anisa Ibrahim
- Somali Health Board, Tukwila, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
| | - Kathleen McGlone West
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Keshet Ronen
- Department of Global Health, University of Washington, Seattle, WA, USA.
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