Project Summary/Abstract In the US, COVID-19 has unveiled a disproportionate health burden in low income and underserved segments of society. In Louisiana, some of the greatest health and economic consequences are evident in our Black communities. There is an urgent need to establish effective testing strategies in these communities as the Fall/Winter virus surges unfold. The Louisiana Clinical and Translational Science (LA CaTS) Center provides the essential infrastructure and key foundational support for biomedical research in our region and is uniquely positioned to lead a community-engaged testing research project to determine differences in COVID-19 testing rates between community-based (churches, community centers, and schools) and medical clinic-based testing sites, and determine approaches that will increase uptake of testing in underserved Black communities in the South. We plan to address these issues using a two-pronged approach. First, we will use a community based participatory research approach to determine differences in SARS-CoV-2 testing rates across distinct types of test sites within five urban underserved Black communities in the American South. We will use a multimedia campaign to promote and conduct RT-PCR testing on salivary samples obtained from 2,000 adults at 1) medical clinics, 2) schools, 3) community centers, and 4) churches (in random order) within five ZIP codes with known low socioeconomic status (SES) and a high representation of Black residents. The primary outcome will be the number of tests performed at each type of test site. We will collect information on age, sex, race, BMI, employment, social determinants of health using an aggregate SES score to identify important correlates of testing rates. Second, we will further leverage our strong and well-integrated partnership with the Baton Rouge Mayor's Healthy City Initiative together with our LA CaTS Community Advisory Boards (CABs) to conduct community-based focus groups to obtain qualitative data about the perceptions and attitudes related to testing access and potential barriers affecting such. We will use this information to determine community-driven approaches that are effective in reducing barriers and create strategies to increase SARS-CoV-2 testing uptake in urban underserved Black communities. Results of this project will greatly increase our understanding of the factors that have led to a disproportionate COVID-19 health burden in these underserved populations and lay the groundwork for developing strategies to reduce these disparities in all underserved Black communities. Resulting data will inform the equitable deployment of future virus/flu testing and a SARS-CoV-2 vaccine.