Title: Eliminating COVID-19 disparities in Arizona in partnership with underserved/vulnerable communities Abstract Arizona has one of the highest COVID-19 positivity test rates (approximately 19%) in the U.S. Positivity rates are disproportionally higher among Arizona's Latinx, American Indian and African American communities. The proposed community driven and culturally congruent intervention aims to increase access to testing by identifying and decreasing barriers to testing in vulnerable and underserved communities across Arizona. The intervention aims at reducing disparities in COVID-19 diagnostics, education, wraparound services and referrals to a primary care provider, with the ultimate goal of improving the health of underserved communities. The proposed approach empowers local communities, meets community members where they are, is data driven, and creates the infrastructure for continued community-driven delivery of care. Following a Community Based Participatory Research (CBPR) orientation, the project will: (a) identify and prioritize testing deserts, (b) coordinate testing at different levels of the social ecosystem, (c) engage and train local Community Health Workers (CHWs) deliver saliva-based COVID-19 testing to vulnerable and underserved community members, (d) deliver test results within 72 hours, (e) provide wrap-around services and provider referrals for those testing positive, and (f) sustain the intervention during a follow-up period. Equality Health Foundation serves as the lead community partner and convener of a growing COVID- 19 Coalition of Communities of Color Partners (CCCCP) from across Arizona. The ASU Biodesign Clinical Testing Laboratory (ABCTL) will provide the saliva-based SARS-CoV-2 molecular diagnostic. The saliva test's main benefits are: a) minimal to no PPE requirements compared to nasopharyngeal (NP) swabs; b) convenience and economy of specimen collection; c) ease of repeat sampling; d) administration by minimally trained CHWs and e) greater sensitivity and consistency of saliva tests than NP swabs. The project aims to administer 29,000 saliva tests, 10,000-12,000 at identified testing deserts during the launching period, doubling the numbers during the follow-up period in Year 1, and adding 5,000 tests in Year 2. A longitudinal evaluation will assess the intervention's impact by comparing randomly selected participants in the R.A.P.I.D. intervention during the launching period (N=500) with a matched comparison group (N=500) randomly selected from standard testing sites. ASU's existing NIMHD-funded U54 Specialized Center of Excellence (RFA-MD-17-005; 5U54MD002316-14) with its Community Advisory Board and in collaboration with key government, community organizations, tribal governments and academic partners is well equipped and eligible to undertake the proposed revision. The aims of this emergency competitive revision match and enhance the aims of the current U54 award and the assembled transdisciplinar...