In the United States, >79 million people have been infected with SARS-CoV-2 and >900,000 died, but cases and deaths disproportionately affect underserved populations. Novel treatments early in disease may transform the pandemic’s course, but strategies that address disparities in timely testing and drug access are essential to maximize impact. Community driven interventions provided access to testing in underserved populations earlier in the pandemic, but need to be tailored to promote test and treat protocols and rapid access to treatment in response to current threats. This proposal will evaluate a systematic and scalable community- engaged test and treat protocol that provides rapid access to self-testing, “next steps” guidance, and local resources to facilitate treatment in underserved populations. We will evaluate a community engagement toolkit, You & Me Healthy Toolkit, developed based on our expertise and experience, to implement community-based test distribution and test and treat responses to the next phase of the COVID-19 pandemic in underserved populations. Our central hypothesis is that that the You & Me Healthy Toolkit will enable rapid design and implementation of a community driven, scientifically robust, and impactful COVID-19 test and treatment intervention. We will leverage successful partnerships and infrastructure established through two large national RADx-UP funded SARS-CoV2 testing and education interventions (SAY YES! COVID TEST, You & Me COVID-Free); an actively enrolling registry of participants interested in community-engaged research (You & Me Healthy Registry); partnerships with community engagement experts (Community Campus Partnerships for Health); and a history of collaboration with 150+ local community partners in Merced County, CA and Pitt County, NC with high proportion minority (Hispanic/Latino/Latinx and Black), high-poverty and low health insurance coverage. We will apply this toolkit to develop a rapid-deployment test and treat protocol implemented through our partners in two communities, launched in direct response to SARS-CoV2 infection surges or at community-identified high-risk events over a 15 month period. We will test this hypothesis through the following specific aims: 1) Evaluate the YMH toolkit ability to rapidly create effective academic- community research partnerships for promoting COVID-19 test access; 2) Document results of at-home tests using a community-engaged scalable reporting approach; 3) Evaluate ability of a test and treat protocol and local resourcing to facilitate timely access to testing, guidance, resource linkage, and therapeutics. This work will demonstrate the value of a generalizable toolkit to promote rapid and effective academic-community partnerships to enable timely testing and access to effective therapeutics in underserved populations in response to COVID-19 surges or transmission threats.

PROJECT NARRATIVE COVID-19 cases and deaths disproportionately affect underserved populations, but strategies that address disparities in timely testing and drug access may transform the pandemic’s course. We will evaluate a community engagement toolkit, You & Me Healthy Toolkit, to develop a rapid-deployment test and treat protocol implemented through our partners in two communities, launched in direct response to SARS-CoV2 infection surges or at community-identified high-risk events over a 15-month period. This work will demonstrate the value of a generalizable toolkit to promote rapid and effective academic-community partnerships to enable timely testing and access to effective therapeutics in underserved populations in response to COVID-19 surges or transmission threats.