Theme: Models of Care Year: 2024
Background: The Test to Protect (T2P) initiative emerged as a community-led response to public health challenges during the COVID-19 pandemic in Nova Scotia, Canada. With over 5,000 volunteers contributing 100,000+ hours providing over 3 million COVID tests, T2P played a pivotal role in the provincial pandemic response. T2P’s success in engaging vulnerable populations, addressing barriers, increasing awareness, and fostering community resilience illustrates the potential of community-led models in other areas of public health, such as HIV and HCV.
Description of model of care: T2P’s success lies in its community-embedded, volunteer-driven approach, utilizing non-healthcare volunteers. The model meets individuals where they are — shelters, food banks, public housing, community spaces such as libraries — and extends beyond testing, linking individuals to treatment, housing support, and vaccines. The model emphasizes iterative innovations, adaptability, and community partnership.
Effectiveness: The de-medicalized, low-barrier outreach demonstrated high engagement and acceptability, enhanced with stakeholder incentives. Over ~1 year, the outreach team supported 13 shelters and 5 public housing buildings with sustained and stable engagement over time, contrasting the trend of decreasing public participation in COVID-safe practices. The model was flexible, enabling the team to visit at preferred weekly frequencies, times of the day, and offer on-site administered testing (n=12,657) and take-home tests (n=29,852). Furthermore, the model built capacity by training shelter staff and clients in COVID protocols and testing. Test kit users indicated a high level of satisfaction, ease of use, and a notable interest in self-determination of health status, leading to increased confidence and safety during the pandemic.
Conclusion:
Client, staff, and volunteer perspectives emphasized the models’ value in providing comprehensive linkage to care, education, and community support for marginalized populations. T2P’s lessons learned encompass broader implications of health self-determination, access, autonomy, and community engagement, providing valuable insights for HIV/HCV future health strategies and positively engaging the public.