PROJECT SUMMARY/ABSTRACT The Prevention of Lower Urinary Tract Symptoms (PLUS) Consortium was established to lay the foundation necessary to study bladder health (BH) in women and girls, including the identification of risk and protective factors for BH using a longitudinal cohort. Factors identified across the spectrum of the PLUS conceptual model, from societal to biologic, will establish the evidence base for intervention studies designed by PLUS researchers and others in the field. The objective of this application is to present the UC San Diego Clinical Research Center (CRC) as a diverse, experienced, committed, and invaluable contributor to the Consortium. We will continue to provide the unique transdisciplinary expertise necessary for the Consortium to advance the study and promotion of BH. Members of our team have extensive experience in transdisciplinary research, epidemiology, longitudinal cohort studies, prevention science, public health, health education, cross cultural research, qualitative research, primary care (Pediatrics, Obstetrics & Gynecology), clinical care of women with LUTS, and are world renown for population-based microbiome research. We boast a history of strong leadership and critical contributions to the foundational work of the Consortium, including leadership in the development and validation of instruments for BH and qualitative research on the Study of Habits, Attitudes, Realities and Experiences (SHARE) and related knowledge, attitudes and beliefs (KAB). UC San Diego is a well-established research institution, funded by the National Institutes of Health, including a sponsored Clinical & Translational Science Award which provides a full spectrum of resources and personnel for the conduct of basic science, translational, epidemiologic, behavioral, and clinical research across the full age spectrum among racially and ethnically diverse communities. In addition to the foundational work of validating the bladder health instrument (BHI) for use in a culturally diverse population, our proposal incorporates cutting edge translational research aimed at identifying a healthy urogenital microbiome. The unique strengths of our application include: a) robust contributions to the foundational work of the Consortium including two team members actively engaged in the design of the planned longitudinal cohort study; b) a history of strong recruitment and retention of ethnically diverse participants for qualitative (SHARE), quantitative clinical trials and longitudinal cohort studies; c) a conceptual model centered around the notion that BH may be mediated through societal, institutional, interpersonal, behavioral and biologic factors via the urogenital microbiome; d) a feasibility pilot study of collection and analysis of voided urine specimens from a longitudinal cohort, which will foster investigations of prevention studies that manipulate the urogenital microbiome (directly or indirectly) through changes in modifiable risk fact...