Designing for Access

Mobile COVID-19 Testing in Underserved Communities | Connecticut | SalivaDirect, Inc. | 2022–2024

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 COVID-19 testing program for underserved communities — free, walk-in, deployed at trusted neighborhood sites. Approximately 100 local leaders and organizations informed program design before a single van deployed.

• 123 community events across Connecticut
• 54% of participants identified as BIPOC
• 59% reported household incomes under $25,000
• 31% were uninsured
• 79% found the service easy to access and comfortable to 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 would not have gone. One recurring site became a mutual referral point: people arrived for testing and connected with food pantry services; food pantry visitors stopped for a test. A partner at that site said having something free, on-site, and walk-in meant everything to the people they served. A community engagement coordinator who invested significant time in the program called it a life-saving resource — and said he gave it his time because he believed in it.

The barrier was not a lack of motivation. It was design.

Paper under peer review: Choate B. et al. “Mobilizing community-driven public health response: increasing access to diagnostic testing for underserved and uninsured individuals in Connecticut through lab-in-a-van partnerships.” AJPM Focus.

Statewide Impact at Scale

Testing, Vaccination & Community Engagement | Colorado | Gary Community Ventures / COVIDCheck Colorado | 2020–2021

2M+ tests. 300K+ vaccines. 80% reduction in operating costs. NPS above 90.

Microgrant model: 10x the community engagement impact at 10% of the canvassing investment.

As Director of Site Operations and Director of Community Engagement, I held senior leadership roles across two functions of one of Colorado’s largest public health mobilizations — a statewide COVID-19 testing and vaccination program built to reach Coloradans across rural, urban, school-based, and community settings.

Site Operations

• Directed operations across 40+ sites, overseeing 500+ staff and volunteers
• Personally designed half of Colorado’s mass vaccination sites — mapping traffic flow and managing day-to-day operations across K–12 schools, universities, and community venues from concept through deployment
• Reduced physical infrastructure costs by 80% while maintaining NPS above 90
• Operationalized mobile, pop-up, and fixed-site service models to expand equitable access across rural, urban, and community settings

Community Engagement

The community engagement strategy was built on a specific premise: that institutions with existing trust in their communities were more effective at driving participation than any amount of external outreach. 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 — 28 anchor partners — spanning CBOs, government agencies, healthcare systems, schools, businesses, and faith-based institutions. What those partnerships made possible went well beyond logistics. Promotoras conducted one-on-one conversations with immigrant families to overcome language, cultural, and systemic barriers to vaccines. Community cultural centers used their social media platforms to educate and activate communities of color and hosted community clinics. Food distribution networks reached Spanish-speaking families directly — tucking vaccine information into food boxes arriving at people’s doors. Community schools hosted clinics for families who had no other trusted access point.

These were not outreach campaigns. They were relationships — and the program worked because we invested in them rather than around them.

• Directed community grantmaking strategy, multilingual outreach infrastructure, and a 230,000+ household canvassing initiative
• Ran the Amplifier Grant program — resourcing trusted community organizations to lead their own outreach rather than delivering messaging through external channels
• Conducted one of the largest statewide stakeholder assessments to inform deployment strategy and resource allocation
• Tested two outreach 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 engage the community was not a detour. It was the strategy.

External resources: Gary Community Ventures Case Study | CPR News Coverage

Designing Across Borders

Multi-Country IPC Initiative & NIH Proposal Development | DRC, Ethiopia, Nigeria, Somalia, Zimbabwe & United States | Dumontel Healthcare Consulting + SalivaDirect, Inc. | 2025–2026

Six countries. One shared framework. Implementation designed for local reality — not institutional convenience.

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

Participants across all five countries were consistent: the problems were shared, the solutions needed to be local, and cross-national collaboration was necessary. Key themes that shaped the proposal:

• IPC is foundational to patient safety and health system resilience — not a supplementary concern
• Standardized frameworks are only viable when adapted to local infrastructure, culture, and health systems
• Policymakers and frontline workers must be engaged together, early enough to shape design — not validate it after the fact
• A phased, evidence-based approach with clear milestones and whole-system engagement — including non-clinical actors — is essential to sustainability

Building on that engagement, I led the full development of a cross-national NIH R21/R33 proposal — including the narrative, specific aims, study design, governance structure, and partnership architecture across five countries. The proposal work is complete and the initiative is being advanced with additional funders.

Executive Summary: APH-LMIC Roundtable on IPC & Diagnostic Testing

Published Research & Field Contributions

• Choate B., et al. (2026). Mobilizing community-driven public health response: increasing access to diagnostic testing for underserved and uninsured individuals in Connecticut through lab-in-a-van partnerships (Details on request; View pre-print →)
• 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 and conference presentations available on request.