PROJECT SUMMARY/ABSTRACT Urgent Supplement to NIMHD Grant U54 MD012392-04 Title of Parent Project: RCMI Center for Health Disparities Research Title of Supplement: NCCU COVID Hesitancy Black/African Americans (B/AA) are suffering disproportionality from COVID-19 and are further burdened by significant COVID-19 health disparities characterized by increased risk, increased incidence, and increased mortality rates linked to systemic bias, racism, historically-based mistrust, and structural barriers and lower health literacy. Leveraging community relationships, technology, and patient-provider relationships/communication are supported as potential solutions to address health care disparities. In the case of COVID-19 related screenings and vaccinations, any solution or intervention must acknowledge and address historically based mistrust and how this mistrust may manifest in vaccine hesitancy. This 2-year supplement, related to parent grant NCCU RCMI titled ?RCMI Center for Health Disparities (RCHDR)? seeks to leverage expertise, collaborations and knowledge gained from the key data collected by ACCORD (Advanced Center for COVID-19 Related Disparities) to address COVID-19 testing concerns and vaccine hesitancy. We hypothesize that a comprehensive program encompassing community engagement, peer support, and mHealth technologies to improve health literacy and is rooted in the social ecological framework could offer a sustainable approach to improving COVID-19 vaccination hesitancy and vaccination uptake. This multidimensional, theory-based project is designed to decrease vaccine hesitancy and increase COVID-19 vaccinations in an urban community and four rural counties will aim to 1) Determine factors related to vaccine acceptance including hesitancy and uptake, 2) Implement and evaluate the reach and effectiveness of a comprehensive intervention to address vaccine hesitancy, 3) Determine the impact and efficacy of strategies listed in AIM 2 and measure changes in vaccine hesitancy over the two project year. From this work, will have a cache of tested messaging, community support, improved community capacity and knowledge, and increased vaccination uptake.