PROJECT SUMMARY/ABSTRACT Progressive disorders of airway protection, such as swallowing disorders (dysphagia) and cough disorders (dystussia), are highly prevalent in PD and have significant negative implications for health and quality of life. In fact, aspiration pneumonia, commonly associated with dysphagia/dystussia, is a leading cause of death in PD. Despite this, approximately 40% of individuals with PD in the United States do not access rehabilitation services or receive specialized care for these potentially life-threatening airway protective deficits. This is compounded by a multitude of health inequities leading to ethnic/racial minorities and those from disadvantaged regions being less likely to receive care. Despite the clear healthcare disparities, there are very few studies examining patient perspectives as it relates to airway protection and no studies that have specifically examined the perspectives and experiences of historically marginalized groups – including Black and Hispanic individuals and those from disadvantaged regions – following airway protective interventions. Our long-term goal is to improve the health outcomes of individuals with PD by increasing airway protective treatment uptake. The overall objective of this application, an administrative supplement to our parent award R01 NS126319-01, is to utilize an embedded mixed methods design, in which we will use qualitative data to (1) understand how participants experience EMST and CST treatment both in-person and via telehealth, (2) examine the impact of treatment barriers and facilitators on treatment adherence and primary treatment outcomes, and (3) qualitatively explore treatment acceptability and satisfaction among Black and Hispanic individuals and those from disadvantaged regions. This supplement will focus on obtaining qualitative data through semi-structured in-depth interviews following treatment to explore treatment acceptability and satisfaction, including their barriers and facilitators. Participants will be purposively selected to ensure representation across traditionally underrepresented racial and ethnic groups, specifically Black and Hispanic individuals and those from disadvantaged regions. The proposed study will be the first to utilize a mixed methodology to elucidate patient perspectives and identify barriers and facilitators to engaging in airway protective rehabilitation in-person and via telehealth. This study will yield critical evidence for refining EMST and CST - increasing personalized, accessible, and equitable airway protective care for pwPD. These findings will also set the stage to culturally align airway protective treatments such that future work can more effectively engage individuals from under-represented and disadvantaged groups.