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.