Project Summary/Abstract The SARS-CoV-2, also known as COVID-19 pandemic has caused disastrous and unprecedented public health and economic consequences in the U.S., seriously affecting Americans' physical and mental health. Death rates attributable to COVID-19 among minority populations are several folds higher than among predominantly White counties. South Florida and specifically Miami-Dade County is an epicenter of the COVID-19 pandemic, where non-Hispanic Blacks and Latinos are overrepresented in COVID-19 related hospitalizations and deaths. Pervasive structural inequities and social determinants of health are the main cause of health disparities due to a complex interaction of multiple factors including individual and societal risk factors. Understanding the impacts of these factors on health and social consequences of the pandemic has broad policy implications, especially for the acceptance of testing and future vaccines. The proposed research will address the impact of COVID-19 on vulnerable minority populations and examine (1) the barriers to testing and uptake of future vaccines, (2) effectiveness of community engagement to increase the uptake of COVID-19 testing in the underserved communities, (2) acceptability, sensitivity and specificity of using less invasive testing methods compared to nasopharyngeal swabs, and (3) assessment of barriers and potential strategies to engage community members and community organizations in COVID-19 testing and vaccine deployment. We propose to conduct community-engaged research studies in collaboration with community- based partners to (a) determine barriers to testing, and uptake of future vaccines, including health literacy, stigma, drug use and financial burden associated with testing, follow-up care, feasibility of effective self- isolation if positive, and perceived effectiveness of testing and vaccination, (b) assessment of the acceptability of extensive community outreach and deployment of a mobile COVID-19 testing unit to geographical areas occupied by underserved and vulnerable populations in close proximity to our community partner, Borinquen Health Care Center (BHCC), and (c) compare the acceptability, sensitivity, and specificity of alternative approaches to obtain samples, including medically administered nasopharyngeal swabs, saliva, and self- swabbing options sampled simultaneously. The goal is to improve understanding of COVID-19-related health disparities, enhance access, effectiveness, and implementation of COVID-19 testing in vulnerable and/or underserved populations and to mobilize the community to develop culturally-appropriate strategies to mitigate the COVID-19 epidemic and increase acceptance of future vaccines. The potential for evidence-based approaches to address COVID-19 disparities will be facilitated by our community-based partners that have the resources to provide community engagement, follow-up care, and public health mitigation for cases who test positive; the PI who ...