RADx-UP and 2-1-1 COVID-19 health communication


What questions and concerns about COVID-19 testing and vaccination are expressed by underserved Americans calling 2-1-1?

What social, ethical and behavioral factors influence COVID-19 testing for specific populations at high risk? How do these groups view the risks and benefits of COVID-19 testing and vaccination?

What communication messages and strategies can be developed and tested to overcome barriers and increase acceptability of testing (as well as vaccinations) among underserved and vulnerable populations?

Many low-income Americans, racial and ethnic minorities, and other marginalized groups live in information-poor environments, are disproportionately exposed to misinformation about COVID-19, consistently face cultural and linguistic barriers in health messaging, and distrust medical, government and scientific institutions and leaders due to a long history of health inequity in the United States. These and other social, cultural and behavioral factors pose significant obstacles to public health efforts to increase population testing and vaccination in a pandemic. Testing and vaccination efforts must be paired with an understanding of the needs and cultures of different communities, and to do that the contexts in which people live must be considered, especially among groups hit hardest by the COVID-19 pandemic.

This study aims to identify factors related to context and content for communicating about COVID-19, and how those factors differ between groups. We aim to apply what we learn to develop health communication messaging that provides information and dispels myths and misinformation related to COVID-19 testing and vaccination beliefs and behaviors.

The study works in close partnership with 2-1-1 helplines in Connecticut, Nebraska, North Carolina, and Washington, all of which have been designated to provide live assistance about COVID-19 in their respective state’s response to the pandemic. Additionally, the project collaborates with a consortium of over 60 community-engaged projects across the United States through the National Institutes of Health (NIH) Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative, facilitated by the Coordination and Data Collection Center led by the Duke Clinical Research Institute and the Center for Health Equity Research at UNC-Chapel Hill.


Alexis Marsh