Barriers to access to COVID-19 early detection in socially vulnerable communities in southern Puerto Rico

Abstract Background: The COVID-19 pandemic has presented challenges around access to prevention strategies. In particular, with the early detection of the virus in socially vulnerable populations (SVC). The main objective of this study was to explore the experiences of community leaders (CL) managing the COVID-19 public health emergency in some SVC in southern Puerto Rico. This data will present an overview of the barriers that still exist around COVID-19 testing. Methods: A qualitative exploratory study was carried out between March 2021 and March 2022. We conducted a total of 27 of in-depth interviews with CLs from southern Puerto Rico. A qualitative codebook was developed using the five domains of the Consolidated Framework for Implementation Research (CFIR) model plus other domains pertinent to the project. Analysis was guided using the Grounded Theory principles. To conduct the analysis, the interviews were transcribed and reviewed to ensure the reliability of the data. A content analysis was performed using the NVivo v.12 program. Results: The following CFIR domains were identified: 1) Intervention characteristics (n=43); 2) Outer Setting (n=186); 3) Inner Setting (n=195); 4) Characteristics of Individuals (n=68); 5) Process (n=17); 6) COVID-19 Pandemic (n=355); 7) Implementation Strategies (n=40); 8) Barriers for Implementation (n=41; 9) Facilitators for Implementation (n=5); and 10) Recommendation (n=45). The results show that there are still barriers for SVC residents to access COVID-19 tests. These barriers are presented in the lack of screening campaigns in the communities, the cost and medical coverage, the perception of safety provided by the vaccine, and the people’s knowledge about COVID-19 tests. Conclusion: It is important to address these barriers to provide tailored and effective health prevention strategies to the SVC.