Mobilizing Community-Driven Public Health: Increasing Access to Diagnostic Testing for Underserved Individuals Through Lab-In-A-Van Partnerships.

Introduction: Underrepresented populations, who often have the highest need for accessible health care, frequently face barriers to accessing services. To address health inequities, researchers evaluated a community-informed lab-in-a-van model that was designed to increase access to COVID-19 testing for vulnerable populations. Methods: Free saliva-based SARS-CoV-2 diagnostic testing was offered between June 2023 and July 2024 at 123 events in Connecticut, U.S., using a Clinical Laboratory Improvement Amendments-certified mobile laboratory. Approximately 100 local leaders and organizations informed the program's design. After providing samples, participants completed an IRB-approved survey; responses were stored using REDCap. Results: Offering on-site testing helped remove barriers and increased access for traditionally underserved communities. Overall, 1,428 individuals were tested, and 838 completed a testing experience survey. Of the respondents, 54% identified as Black, Indigenous, People of Color; 59% reported an annual household income <$25,000; and 31% were uninsured. Participants reported that the service was easy to access (74%) and comfortable to use (75%); 29% received their first COVID-19 test, and 48% were unaware of alternative testing options. Results were reported in an average of 3.1 hours, enabling many participants to receive their diagnostic results during the community event; 48 positive samples were identified. Conclusions: This program evaluation demonstrates that community-informed mobile testing programs capable of delivering same-day diagnostic results can expand access to testing among underserved populations and may represent a scalable strategy for improving diagnostic access during future public health emergencies.