The Duke Global Health Innovation Center in cooperation with Bass Connections is giving Duke University students the chance to tackle complex problems throughout the world. The program—named in honor of donors Anne T. and Robert M. Bass—exemplifies Duke University’s commitment to integrating research, education, and civic engagement. This year, two GHIC colleagues—Andrea Thoumi and Diana Silimperi—will direct research teams in applying classroom training and an entrepreneurial spirit to solve pressing local problems with global application.
Community-based Testing and Primary Care to Mitigate COVID-19 Transmission
COVID-19 has exposed a need for rapid, accessible testing and clinical assessment in vulnerable populations, along with effective care that reaches communities in the longer-term. In Durham County, Black and Latinx communities are bearing disproportionate COVID-19 morbidity and mortality. The roots of health disparities are complex and include underlying structural racism and various socioeconomic factors. COVID-19 services have largely been implemented within existing health service networks that exclude Black and Latinx communities, an approach that has predictably led to health 
disparities and an inability to mitigate the pandemic in the United States. Without new, community-based models of care delivery, this problem will continue to worsen.
Andrea Thoumi, Research Director, Global Health, Duke-Margolis Center for Health Policy and Assistant Director of Research at GHIC, is a team leader on this project to strengthen collaboration between clinical, policy, and community partners, and assess the long-term sustainability of programs.
To address these issues, the team will:
- Implement a community-based mobile testing program.Team members will work closely with community partners to illuminate the historical contexts of health disparities in order to ensure that services are culturally sensitive. By offering information and enrollment to patients at community sites, the team will increase equity in COVID-19 research studies.
- Investigate care delivery models for strengthening primary care and community-based care.Team members will assess the scalability of the pilot program to provide community-based clinical services in partnership with community organizations. Through this assessment, the team will identify culturally appropriate, community-based care efforts that meet the specific health needs of the community. Team members will develop case studies and disseminate results of the pilot program to key stakeholders and agencies involved in COVID-19 response. This team’s research will inform care delivery redesign efforts and policy discussions in North Carolina concerning health disparities within underserved communities.
Assessing an Innovative Community-based Response to COVID-19 in Rural North Carolina
In Pamlico County, residents are particularly vulnerable to COVID-19. In addition to the frequent exposure to environmental disasters, approximately 30% of the 12,000 residents are 65 years old or older, almost 15% live in poverty, and a high proportion have chronic illnesses, including diabetes mellitus, obesity, heart disease, and mental health conditions.
Diana Silimperi, MD, a Duke University visiting professor and advisor to GHIC, helped launch a COVID-19 Community Task Force in April to assist the Pamlico County Health Department and to engage the community in mitigating the spread of COVID-19. She will also lead this project team in integrating reverse innovation and public-private community partnerships to develop a community-based response network aimed at improving health outcomes in underserved rural communities.
Project team members will address three main goals:
- Internal evaluation of the CCTF. The team will create survey tools, interview primary stakeholders, and capture implementation metrics to understand the model.
- Refine the CCTF model. Team members will address the sustainable elements of CCTF, such as distribution of masks, development of a reserve medical corps to assist with contact tracing, educating community organizations about virus transmission, and minimizing the risk of infection. The team will also consider how the Community Response Network platform, which brought together 120 community organizations, can be adapted for an integrated disaster response beyond the pandemic.
- Create a community-based service and engagement model. The team will incorporate digital and reverse innovation to focus on chronic conditions. The final event will be a community discussion about the CCTF model, potential partners, sources of funding, and a potential operational plan.
For information about Bass Connections, go to: https://bassconnections.duke.edu/.