PROJECT SUMMARY The global SARS-CoV-2 pandemic is the worst health crisis the United States and world have faced in a century. Although this highly contagious virus has infected tens of millions of Americans already, the pandemic is far from over, and the disease burdens continue to be disproportionately born by historically underserved populations such as Latinx communities. Nationally, Latinx people with COVID-19 are hospitalized at four times the rate of Whites and have much higher rates of morbidity and mortality. This disparity is notable in Oregon, where the 13% of our population that is Latinx represents approximately 24% of COVID-19 cases. Yet, vaccination rates for Latinx remain below the state average. Thus, an urgent need exists to reach Oregon’s Latinx community with public health and prevention messages that emphasize the value of continued COVID-19 testing and that address vaccine hesitancy. This project will build upon our successful RADx-UP Phase I culturally-tailored community outreach and testing program through the implementation of Phase II goals of increasing the reach and uptake of testing and decreasing vaccine hesitancy in Latinx individuals in Oregon. The project will maintain and expand a world-class team of prevention scientists, public health experts, Latinx researchers, community partners, and biologists who have been working together to conduct SARS-CoV-2 diagnostic testing since March 2020. This team established a CLIA-certified laboratory and honed molecular testing protocols, procured millions of dollars of diagnostic testing equipment and supplies, and partnered with county public health offices and hospitals throughout the state to conduct testing. The team has been engaged in comprehensive community partnerships using community-based participatory research methods in Phase I to deliver a culturally-tailored intervention that shows preliminary efficacy in increasing testing among Latinx individuals. Building on the lessons learned in the first 6 months of our Phase I RADX-UP testing, we will refocus our existing testing program to broaden our reach by partnering with state and community organizations offering other services to Latinx communities across Oregon. With continued support from the Latinx Community and Scientific Advisory Board, the project will refocus to support the testing of 100 individuals each month across the state of Oregon, focusing specifically on locating testing events at venues that serve Latinx individuals (e.g., mobile Mexican Consulate events across the state). The previously launched health intervention (Promotores de Salud) will also be refocused to promote the benefits of continued testing and vaccination uptake, and barriers to these important health behaviors will be evaluated. Over time, this project will continue to help communities institutionalize optimal local testing frameworks that are sustainable. The resulting testing and structures and systems will be poised for future scale-up to other vulnerable communities and/or for other public health purposes. This project is expected to lead to a major reduction in COVID-19 health disparities in underserved populations.

PROJECT NARRATIVE The global SARS-CoV-2 pandemic is the worst public health crisis faced by the United States and the world in a century, with a disproportionate burden of disease and mortality experienced by vulnerable and historically underserved populations. The proposed project will continue to address the ongoing disparities in COVID-19 cases among underserved Latinx populations in Oregon by collaborating with state, county, and community partners to optimize testing locations across the state of Oregon and deliver a culturally tailored health intervention to increase testing, improve health behaviors, and reduce vaccine hesitancy among Latinx individuals. By leveraging expertise in prevention science, genomics, and community-based participatory research, this project will support community partners in implementing and sustaining structures and systems for COVID-19 testing and health promotion activities that can be leveraged to serve other vulnerable communities or for related public health efforts.