The United States experienced higher mortality than any other nation due to COVID-19, with nearly 13.5 million cases and over 268,103 deaths. Due to the limited ability to socially distance, poor ventilation, and limited hygiene supplies, U.S. prisons and jails observed explosive transmission of SARS-CoV-2, accounting for the 10 largest U.S. outbreaks. Since 95% of criminal justice-involved individuals reentered society, COVID-19 transmission extended beyond those who were incarcerated. Upon reentering the community, justice-involved individuals faced high rates of homelessness, while many others lived in congregate settings such as converted hotels and halfway houses. The increased risk of SARS-CoV-2 while incarcerated, coupled with the likelihood of living in congregate settings after incarceration, created conditions conducive to rapid COVID-19 transmission, which was critical to address in efforts to gain control of the pandemic in the United States. 

The study aimed to test the impact and cost-effectiveness of an intervention to mitigate SARS-CoV-2 transmission among justice-involved individuals recently released from incarceration. Researchers conducted a randomized trial to compare the effectiveness of an onsite Point-of-Care SARS-CoV-2 testing and education intervention, which included community health workers (CHWs) as a central component, against the standard of care at a community-based organization (CBO) providing services to justice-involved individuals in New York City. The study measured the costs of testing, education, and navigation and explored the cost-effectiveness of the onsite Point-of-Care intervention compared to the standard of care.