Building Community-Centered Strategies with Connect2Test: Understanding Barriers and Building Solutions

Citation: Mauricio, A.M., Cioffi, C.C., Gau, J.G., Fernandes, L., Sanders, A., & Nay, K. (2025). A brief motivational enhancement intervention to promote COVID-19 testing and vaccination among people who inject drugs: A randomized controlled trial.

For many people who use syringe exchange services, access to healthcare—especially vaccinations—isn’t simple. With the Connect2Test program, we worked alongside community partners to create an approach that makes getting vaccinated against COVID-19 easier and more accessible. Here’s what we learned and how it can help others.

What We Will Cover

Challenges to vaccination among people who inject drugs in Oregon
How Connect2Test complements contingency management strategies
The effectiveness of brief motivational interventions in public health
Future directions for Connect2Test interventions

The Connect2Test Model

What It Is: Connect2Test is a program designed to encourage people who use syringe exchange services to get vaccinated. The intervention is a one to two minute conversation with syringe exchange staff or volunteers who understand their needs and are already trusted in the community. The goal is to make vaccines feel more accessible and to empower individuals to make informed choices about their health.

Why It Works: Grounded in the Information-Motivation-Behavioral (IMB) skills model, Connect2Test emphasizes:

Information: Providing accurate, digestible facts about COVID-19 and vaccines.
Motivation: Using strengths-based dialogue to explore personal reasons for vaccination.
Behavioral Skills: Offering practical steps to access vaccines conveniently.

Key Findings

Increased Vaccine Uptake: People who participated in Connect2Test had nearly four times the odds of receiving a COVID-19 vaccine during a 9-month follow-up compared to those in the control group.
Limited Impact on Testing: Connect2Test did not significantly improve COVID-19 testing rates, possibly due to the high baseline testing rates among participants or the brevity of the intervention.
Cost-Effectiveness: The intervention cost $45 per participant, translating to $83.33 per additional vaccine administered—a cost-effective strategy considering the broader public health benefits of vaccination.
Ease of Implementation: Conversations averaged about one minute, ensuring minimal disruption to syringe exchange program workflows.
High Fidelity: Staff adhered to the intervention strategies 81–99% of the time, demonstrating its feasibility.

Reducing Barriers and Building Trust

Syringe exchange programs are already trusted spaces where people who use drugs feel comfortable accessing resources. By adding vaccination services and quick conversations with staff, Connect2Test makes it easier for people to get vaccinated without extra travel or stress.

Many people who use drugs have had negative experiences with the healthcare system, which can lead to hesitation about seeking care. Connect2Test focuses on respect by using supportive, nonjudgmental conversations to help people feel confident in their decisions.

Offering financial incentives along with motivational conversations has been effective in encouraging participation. By combining these strategies, Connect2Test makes healthcare feel more accessible and welcoming.

Lessons for Future Programs

Simple approaches work best. Short conversations and providing services in one location are often more effective than complicated or time-consuming programs. Partnering with trusted local organizations, like syringe exchange programs, is key to connecting with people and building trust. Listening to the community is also important in this process. Programs that are designed with input from the people they serve are more likely to meet their needs and succeed.

Moving Forward Together

Connect2Test shows how small changes can make a big difference. By combining clear communication, respectful support, and practical access, this program helped more people feel ready to get vaccinated. These lessons can help shape other health initiatives aimed at reducing barriers and creating healthier communities.

This study was conducted in partnership with HIV Alliance as part of the National Institutes of Health Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP). Data were collected from August 2022 to April 2023, with participation from 349 individuals across Oregon.