Culturally targeted messaging and racial equity in SARS-CoV-2 antibody testing by multiplex salivary measurement: Protocol overview of a SeroNet investigation

Better understanding racial disparities observed during the COVID-19 pandemic can be aided by SARS-CoV-2 serology testing. However, racial minorities may be underrepresented in serosurveillance efforts not only due to lack of testing accessibility, but also due to hesitancy towards participating in antibody testing programs stemming from medical mistrust. We designed a randomized control trial to evaluate how non-invasive salivary antibody testing and culturally targeted communication might be used to promote racial equity in uptake of SARS-CoV-2 serology testing during the COVID-19 pandemic. To evaluate these approaches, we recruited African American and White American participants from Flint, Michigan. Participants viewed a novel, animated didactic video about SARS-CoV-2 antibody testing, with half of African Americans viewing a culturally targeted version. We measured cognitive and affective responses that indicated receptivity to SARS-CoV-2 serology testing. We also provided a non-invasive salivary antibody screening opportunity, and we measured screening uptake as a behavioral outcome. Finally, we measured baseline sociodemographic, psychological, and health factors that could affect these responses. In addition to evaluating health communication approaches, multiplex SARS-CoV-2 antibody profiles can be subsequently linked to prescreen measures, and to inflammatory markers that were concomitantly measured in whole saliva. Ultimately, we aim to reduce COVID-19 racial disparities and bolster future pandemic preparedness through promoting equity in understanding and uptake of serology testing.