PROJECT SUMMARY/ABSTRACT End of life and palliative care (EOLPC) seeks to enhance quality of life for those with serious illness and their caregivers. The need for and delivery of EOLPC have far exceeded the research that provides evidence of best practices. Small, single-site trials, unrepresentative study cohorts, and studies lacking sufficient rigor hamper provision of high-quality EOLPC. While other fields have advanced their evidence through large, diverse, multi-site trials, EOLPC research has been impeded by an insufficient infrastructure and scientific workforce. The primary goals of this U2C application are to increase the productivity and impact of the Palliative Care Research Cooperative Group (PCRC), its ability to facilitate the conduct of high-quality, effective clinical research, and to expand the number and expertise of palliative care researchers in conducting multi-site clinical trials. The PCRC strives to advance the science of EOLPC by providing investigators with the broad range of support necessary to conduct large scale, multi-site clinical trials and other research studies. This support includes training opportunities, pilot grant awards, access to a large, centralized repository of data from EOLPC studies, methodologic consultation, administrative coordination of research activities, and access to a large network of potential study enrollment sites. Structurally, the PCRC consists of six synergistic components, each led by a senior EOLPC researcher. The Project Coordinating Center coordinates overall administration of the PCRC. The Investigator Development Center builds the skills of EOLPC researchers. Four Cores provide methodological expertise: Data, Informatics, and Statistics; Measurement; Caregiver Research; and Clinical Studies/Methodology. The U2C PCRC application addresses Scientific, Operational, Capacity- building, and Collaborative Aims. By accomplishing these aims, the PCRC will expand its ability to support a robust community of interdisciplinary EOLPC researchers who address topics that guide the delivery of palliative care with an ultimate goal of improving the lives of patients with serious illness and their caregivers.

PROJECT NARRATIVE Home health aides provide hands on care to the approximately 90 million seriously ill Americans receiving homecare from community-based organizations. Home health aides are overwhelmingly women, and predominantly from minority populations, and often live at or near the federal poverty level. They have been at the frontlines of health care, experiencing significant risk, yet are often invisible.1. In this study, the Palliative Care Research Cooperative Group (PCRC) and its community partners will identify the social, cultural, and ethical factors at the individual and community levels that support COVID-19 vaccination, then design an intervention to promote COVID-19 vaccination among the understudied, underserved, underrepresented population of home health aides.