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This study is a prospective, population-based cohort of individuals with a history of SARS-CoV-2 infection and those without past infection through multiple recruitment sources. The main study goal is to track health status over time, within the diverse populations of Arizona and to identify the long-term consequences of COVID-19 on health and well-being. A total of 2,881 study participants (16.2% with a confirmed SARS-CoV-2 infection) have been enrolled as of December 22, 2020, with a target enrollment of 10,000 participants and a planned follow-up of at least 2 years. This manuscript describes a scalable study design that utilizes a wide range of recruitment sources, leveraging electronic data collection to capture and link longitudinal participant data on the current and emerging issues associated with the COVID-19 pandemic. The cohort is built within a collaborative infrastructure that includes new and established partnerships with multiple stakeholders, including the state's public universities, local health departments, tribes, and tribal organizations. Challenges remain for ensuring recruitment of diverse participants and participant retention, although the electronic data management system and timing of participant contact can help to mitigate these problems.

This study examined the experience of caregiving during a pandemic by asking five questions about how COVID-19 was impacting twenty American Indian caregivers providing care to a family member who was disabled, elderly, or had a chronic health condition. Interviews were conducted via Zoom. Themes identified were concern about the care recipient contracting COVID-19, increased caregiving intensity, increased Medical care issues, changes to caregiver health and health behaviors, and support received and increased need for support during the pandemic (material and emotional). Responses indicate that tribes and American Indian health organizations should initiate services that can support caregivers during the pandemic or make changes to their caregiver programs.

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