BackgroundRural communities were disproportionately impacted by the COVID-19 pandemic. Current and future pandemic preparedness in rural areas could be aided by serological (antibody) testing. However, benefits to be gained from serosurveillance are challenged both by the accessibility of serological testing resources in hard-to-reach rural areas, and by likely hesitancy towards their use in many rural communities. Trials are needed to evaluate outreach and health communication strategies that can increase rural receptivity towards serosurveillance.MethodsWe conducted a two-arm randomized controlled trial that recruited N = 194 participants from rural northern Michigan. In a single online session lasting approximately 45 min, participants were randomly assigned to view either a general SARS-CoV-2 antibody testing didactic video, or a rural targeted didactic video co-created with a rural community advisory board and containing unique rural messaging. Primary self-report outcomes included receptivity to antibody testing, as well as activation of medical mistrust and concern for rural-discrimination in future SARS-CoV-2 antibody testing. We also developed and provided an opportunity to participate in a home-based salivary antibody screening program. In addition to assessing the feasibility and fidelity of this program, we assessed interest and full participation in the serosurveillance program as behavioral outcomes.DiscussionFindings from this study can guide the use of home-based screening programs and targeted health communication strategies to promote greater uptake of health resources in rural communities. In doing so, study results can also guide public health strategies to reduce pandemic-related and other rural health disparities.

Mild traumatic brain injury (mTBI) is a prevalent neurological condition, affecting millions worldwide, and frequently resulting in persistent cognitive impairment that significantly impacts daily functioning. Current clinical management and recommendations lack evidence based therapeutic interventions, with treatment approaches limited to symptom monitoring and activity modification. Non-pharmaceutical interventions are needed to promote cognitive recovery and mitigate long-term consequences of mTBI. The goal of this randomized control pilot study is to evaluate the feasibility and preliminary efficacy of a symptom-guided and virtually delivered aerobic exercise intervention for improving cognitive function following mTBI. We are conducting a 12-week pilot randomized control trial of exercise to promote recovery from mTBI, which aims to recruit 24 participants who have suffered an mTBI within the last year and are between the ages of 18-55 years old. Participants are randomly assigned to one of two groups: an intervention group receiving 90min of virtually-delivered, symptom-guided aerobic exercise weekly for 12 weeks, or a control group receiving 90min of virtually-delivered balance exercises weekly for 12 weeks. Comprehensive assessments, including cognitive testing and multimodal neuroimaging, were conducted pre and post intervention. We implement physical activity monitoring during weeks 1, 6, and 12 using accelerometry to measure behavior changes. This study will establish the feasibility of virtual exercise delivery in mTBI populations and preliminary evidence regarding cognitive and brain health benefits of aerobic exercise in mTBI. Results will inform future large-scale trials and contribute to an accessible, evidence-based intervention for cognitive recovery after mTBI.