Title: COVID-19 Exposure, Response, Physical and Mental Health Sequalae among Nurses in New York State Project Summary Since the declaration of the COVID-19 pandemic, there have been over 7.6 million COVID-19 cases and over 214,000 deaths in the United States (US). Simultaneously, the physical and mental health impacts of health care workers managing the COVID-19 pandemic (frontline workers) has been increasingly documented, and include increased rates of depression, anxiety, post-traumatic stress disorder, and COVID-19 infection. Associations between individual-level and organizational-level characteristics on risk of COVID-19 infection and mental health outcomes, however, are under explored among frontline nurses. To address these gaps, this project will 1) evaluate the associations between COVID-19 related burnout, coping strategies, on mental health symptoms 2) examine the impact of organizational-level factors on report of COVID-19 symptoms and diagnosis and 3) identify how individual and organizational-level protective factors may buffer adverse mental health outcomes. To accomplish these aims, we will leverage our significant expertise in COVID-19 and occupation health disease disparities research, community-engaged and mixed-method approaches, and our partnership with the PEF Union at the University Hospital of Brooklyn, to recruit 2,000 frontline nurses in New York State to complete a cross-sectional online survey, as well as in-depth qualitative interviews in a subset (N=100) to provide a mixed method dataset of COVID-19 exposures and impacts among a COVID-19 vulnerable occupational group. In this proposed project, we seek to address several key needs as identified by nurses through our union partnerships, including nurse-specific data on inadequate access and training on PPE use, mental health impacts (depression, anxiety, post-traumatic stress disorder), quantitative and qualitative data on how nurses are coping during the COVID-19 pandemic period. Through our study, we will address the NORA “Healthcare and Social Assistance” sector (62) and the “Healthy Work Design and Well-Being Program” cross-sector. Further, these research questions will be examined within the context of the New York State nursing workforce, which was the early epicenter of the US COVID-19 pandemic and currently has the 4th highest number of COVID-19 cases and the highest number of COVID-19 deaths. Findings from this study will contribute to the development of multilevel organizational strategies to support frontline workers by elucidating factors associated with COVID-19 stress and physical and mental health and identifying modifiable factors to improve well-being among vulnerable occupational groups.