Overcoming Barriers to COVID-19 Testing and Vaccination in Vulnerable Populations: The Role of Federally Qualified Health Centers and Community-Based Organization Open Access

Abstract

African Americans, Hispanics, Native Americans, and Pacific Islanders are disproportionally affected by diabetes and COVID-19. In Georgia, the prevalence of diabetes is higher than the national average, putting these individuals living with diabetes at a greater risk of severe illness and death from COVID-19. The thesis investigates the strategies implemented by Federally Qualified Health Centers (FQHCs) and Community-Based Organizations (CBOs) in Georgia to increase COVID-19 testing and vaccination rates among vulnerable populations with a focus on people living with diabetes. The findings reveal that despite efforts made, significant testing and vaccination gaps exist in rural and underserved areas and the study identifies successful strategies for closing existing testing and vaccination gaps. Thematic analysis of the interview data resulted in eight main themes, including services and resources affected by COVID-19, barriers to testing, and strategies to address testing and vaccination needs. The results also emphasize the importance of education, healthcare resources, transportation, and health literacy in reducing the disproportionate impact of COVID-19 and improving access to testing and vaccination. The thesis concludes by emphasizing the need for partnerships between healthcare providers, public health agencies, and community organizations to ensure the effective delivery of care and support to vulnerable populations during pandemics. Increased investment in leadership and workforce development, data and IT capabilities, and public health funding is also necessary to ensure equal access to testing and care for vulnerable populations. The findings of this thesis will inform public health policies for ensuring equitable access to healthcare services for individuals living with diabetes and other vulnerable populations. 

Table of Contents

Table of contents 

CHAPTER 1: INTRODUCTION 1 

CHAPTER 2: LITERATURE REVIEW 3 

2.1. THE RELATIONSHIP BETWEEN COVID-19 AND DIABETES 3 

2.2. THE ROLE OF FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) AND COMMUNITY-BASED ORGANIZATIONS (CBOS) IN COVID-19 AND DIABETES CARE 6 

2.3. CHALLENGES FACED BY FQHCS AND CBOS IN INCREASING TESTING AND VACCINATION 9 

CHAPTER 3: METHODS 12 

STUDY DESIGN AND INSTRUMENTS: 12 

SAMPLE: 13 

DATA COLLECTION: 14 

DATA ANALYSIS: 15 

ETHICAL CONSIDERATIONS 16 

CHAPTER 4: RESULTS 17 

OVERVIEW OF PARTICIPANTS 17 

THEMES 18 

CHAPTER 5: DISCUSSION 30 

APPENDIX 38 

I. CODEBOOK 38 

II. INTERVIEW GUIDE 41 

REFERENCES: 43 

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Diabetes COVID-19 COVID-19 Testing Georgia COVID-19 Vaccination
Committee Chair / Thesis Advisor	Dr. Mary Beth Weber, PhD, MPH, Emory University Dr. Leslie Johnson, PhD, MPH, MLitt, Emory University

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