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Montana State University will study what COVID-19 testing strategies are the most effective in underserved populations in Montana and Washington after receiving a federal grant.

The $1.8 million grant is part of a National Institutes of Health initiative to study the rapid acceleration of tests associated with the COVID-19 pandemic.

The university’s Center for American Indian and Rural Health Equity, or CAIRHE, will lead the two-year study in partnership with the University of Washington.

The $1.4 billion NIH program was started in the initial phases of the pandemic to help scale up testing across the country, according to the project description. A portion of those NIH dollars is specifically for underserved and vulnerable populations that are hardest hit by the virus.

“Underserved communities, particularly tribes, have some of the greatest health disparities in the state due to many factors, including lack of health care, poverty and food insecurity due to current and historic injustice,” said Alexandra Adams, director of CAIRHE and main researcher for the new study.

In an email to the Chronicle, Adams said those issues increase rates of chronic disease, which, combined with issues accessing COVID testing and the inability to quarantine due to overcrowded housing, leads to increased death rates.

The project has identified two sites to study the usability of home-tests, the Flathead Reservation with the Confederated Salish and Kootenai Tribes in Montana and Yakima Valley’s large Latino population in Washington.

Adams said the researchers chose the two underserved areas because MSU and UW have a history of working there.

“These two communities are also connected by migrant workers (who) move between the communities for work,” she said.

The Flathead site will recruit 200 participants who will be randomly divided into two testing groups. The passive testing group will receive tests kits via mail and an active testing group will get test kits delivered to their home, with the support of a community health worker.

The Yakima Valley research site will be structured similarly.

Researchers are expecting that home-based testing will be more efficient and better accepted when the test kits are delivered to their door by community members in the active testing group.

Participants at both locations will also receive culturally adapted printed and video instructions and a survey on their current symptoms and medical conditions, according to a news release.

Adams said the study will use test kits the researchers create, but they are working with several companies to try to obtain home-based tests that were recently approved by the Food and Drug Administration.

The study is funded for two years but Adams said the majority of the work would need to be completed in the first year. The results will then be used to help Montana and Washington better serve their Native and Latino populations, she said.

The Montana part of the project will be led by Adams and Selena Ahmed at CAIRHE and Virgil Dupuis and Wendy Westbroek at Salish Kootenai College.

MSU will head the study but has partnered with entities in Montana and Washington, including the University of Washington’s School of Medicine and Institute of Translational Health Serves, Seattle’s Fred Hutchinson Cancer Research Center in Seattle, Salish Kootenai College and the Confederated Salish and Kootenai Tribes.

Each study location will have its own local advisory board.

Jason Carter, MSU vice president for research, economic development and graduate education, said in a statement that the CAIRHE team is experienced in building meaningful and impactful partnerships.

“Montana State is committed to building, strong, equitable and sustainable partnerships with tribal nations, as well as the University of Washington’s ITHS program,” he said.

Adams said the goal is to make COVID-19 testing easier and more understandable to underserved populations to help reduce the spread of the virus.

“There is a lot of misinformation about COVID and misunderstanding of testing results,” she said. “We hope that our work will help make testing more accessible and the results easier to understand and act on.”

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Liz Weber can be reached at or 582-2633.