Case 01
Designing for access · Connecticut

Mobile testing in communities that had no other access point

29% of participants received their first COVID-19 test — and 48% didn't know where else in their community they could get tested.

As program director, I designed and led a mobile, saliva-based testing initiative — free, walk-in, deployed at trusted neighborhood sites. Roughly 100 local leaders and organizations informed the design before a single van deployed.

123 community events across Connecticut

54% of participants identified as BIPOC

59% reported household incomes under $25,000

79% found the service easy to access and use

The program was built around how people actually live. Participants said it was the only reason they got tested — that without it coming to them, they simply wouldn't have gone. One recurring site became a mutual referral point: people arrived for testing and connected with food pantry services; pantry visitors stopped for a test.

The barrier was not a lack of motivation. It was design.
What made it work

Inviting trusted community partners to shape the program before launch — not as outreach, but as design partners — meant the work met people where they already were, on terms that already worked for them.

Choate B., et al. (accepted). "Increasing access to diagnostic testing for underserved and uninsured individuals through lab-in-a-van partnerships." AJPM Focus. View pre-print →
Case 02
Statewide impact at scale · Colorado

One of Colorado's largest public health mobilizations

1.9M tests. Hundreds of thousands of vaccines. 80% reduction in operating costs. NPS above 90.

As Director of Site Operations and Director of Community Engagement, I held senior leadership roles across two functions of a statewide testing and vaccination program built to reach Coloradans across rural, urban, school-based, and community settings.

Site operations

Directed operations across 40+ sites and 500+ staff and volunteers

Personally designed half of Colorado's mass vaccination sites

Reduced physical infrastructure costs by 80%, NPS above 90

Built mobile, pop-up, and fixed-site models for equitable access

Community engagement

The strategy was built on a premise: organizations with existing trust in their communities drive participation more effectively than any amount of external messaging. Rather than asking those organizations to share our materials, we resourced them to lead their own. The result was a network of 87 partner organizations — promotoras holding one-on-one conversations with immigrant families, cultural centers hosting clinics, food networks tucking vaccine information into boxes arriving at people's doors.

We tested two models head to head: professional canvassing versus microgrants to trusted community organizations. The microgrant approach cost roughly 10% of the canvassing investment and yielded 10 times the engagement impact.

Slowing down to build relationships wasn't a detour. It was the strategy.
What made it work

Resourcing organizations with existing community trust to lead their own engagement — rather than asking them to amplify external messaging — produced ten times the participation impact at a tenth of the cost.

Case 03
Designing across borders · DRC, Ethiopia, Nigeria, Somalia, Zimbabwe & U.S.

Six countries, one shared framework

Implementation designed for local reality — not institutional convenience.

I designed and facilitated a multi-country roundtable convening public health and laboratory leaders across five African nations and the United States — built not to validate a model already decided, but to let real-world conditions shape the design from the start.

Infection prevention is foundational, not supplementary

Standardized frameworks must adapt to local infrastructure

Policymakers and frontline workers engaged together, early

A phased, whole-system approach is essential to sustainability

Building on that engagement, I led the full development of a cross-national NIH R21/R33 proposal — the narrative, specific aims, study design, governance structure, and partnership architecture across five countries.

When the people who will run a program help shape it from the start, the design holds up where it matters most.
What made it work

Convening implementers and policymakers together — before the proposal narrative was set — surfaced what would actually work locally, so the funded design fit the ground reality of every country it would reach.

Published research & field contributions

A selection of contributions to the field.

Choate B., et al. (accepted). Increasing access to diagnostic testing for underserved and uninsured individuals through lab-in-a-van partnerships. AJPM Focus. View →

Wyllie A.L., Choate B., et al. (2024). Scalable solutions for global health: the SalivaDirect model. Frontiers in Cellular and Infection Microbiology. View →

Salzano L., Narayanan N., Tobik E.R., Choate B., et al. (2024). Diagnostic testing preferences and implications for future health systems design. PLOS Global Public Health. View →

Tobik E.R., Kitfield-Vernon L., Thomas R., Choate B., et al. (2022). Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe. Expert Review of Molecular Diagnostics. View →

Additional publications, conference presentations, and examples available on request.

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