ABSTRACT This supplemental application (PA-18-591) is submitted in response to NOT-MD-20-019 to create a wealth of knowledge regarding minority women’s health that will contribute to a better understanding of the biological, behavioral, and socio-economic factors contributing to these women’s and their family’s health disparities in the age of COVID-19. The Meharry Center for Women’s Health Research (CWHR) is proposing a partnership with the Young Women’s Christian Association (YWCA), Towards Ending Societal barriers to COVID-19 Testing in the United States- the TEST-US study, to conduct a community engaged research project of YWCA service recipients during the response to COVID-19. The Meharry/YWCA partnership will provide pilot data for a larger multiyear longitudinal cohort study. Given the 2.2 million families served by the YWCA across the USA (204 locations), the larger multisite study will aid in informing the nation about the broad impact of the pandemic on diverse populations. The TEST-US pilot and cohort study will be conducted in collaboration with YWCA staff and trustees in combination with a community advisory board already established in our Research Centers in Minority Institutions (RCMI) community engaged research core. This structure will enable shared governance of data and ensure that findings are disseminated to the respective communities served. The specific aims of this supplemental application are 1) To design a community engaged research project examining the impact of racial/ethnic discrimination on COVID-19 testing in minority women and their families; and 2) To investigate how racial/ethnic discrimination affects access to COVID-19 testing among minority women and their families receiving services from the YWCA in Nashville and El Paso. The TEST-US study is innovative in that there are no existing community engaged research projects addressing how access to COVID-19 testing is affected by living in resource-restricted communities among racial/ethnic minority women. By studying the diverse families served by the YWCA, in the mid-south and on the Texas-Mexico border, we will improve our understanding of those factors that contribute to the tremendous health disparities that women of color and their families face during the COVID-19 pandemic. Results from this study will provide preliminary data on these disparate communities and then provide a road map to expand geographic representation among YWCA sites nationally in a future study. Our findings will aid in developing strategies and interventions while informing policy that may eliminate the distress, morbidity, and mortality that has resulted from the unique impact off the pandemic on communities of color.

PROJECT NARRATIVE COVID-19, caused by infection with SARS-CoV-2, has resulted in a global pandemic with reports that rates of infection or severe outcomes are more common in vulnerable populations in the US. In this supplemental application we propose to conduct a community engaged research project of YWCA service recipients during the response to COVID-19. We hope to create a wealth of knowledge regarding minority women's health that will contribute to a better understanding of the biological, behavioral, and socio-economic factors contributing to these women's and their family's health disparities in the age of COVID-19.