Women Veterans are the fastest-growing segment of users in the Veterans Health Administration (VA). Their numbers are projected to increase by 73%, from 9.3% to 16.4%, between 2015 and 2043. Despite VA investment in improving care for women Veterans, gender disparities persist in cardiovascular (CV) and diabetes risk factor control. Also, the rate of perinatal depression among women Veterans is higher than that among civilian women, which is of particular concern given the association between perinatal depression and suicidality. Barriers to care for women Veterans include distance to VA care, rurality, competing work and caregiving responsibilities, comorbid mental health issues, and harassment on VA grounds. Improvements are still needed to increase women Veterans’ access to and engagement in convenient, safe, evidence-based, patient-centered care that achieves the VA “lane of effort” of Veterans’ “lifelong health, well-being, and resilience.” Since its inception in 2015, the Enhancing Mental and Physical health of Women through Engagement and Retention (EMPOWER) QUERI 1.0 team has focused on implementing gender-tailored care models for women Veteran patients. In EMPOWER 1.0 studies, women expressed preferences for gender- specific (women only) care and for virtual care options. Therefore, our EMPOWER 2.0 Impact Goal is to expand access to virtual, evidence-based, preventive lifestyle and mental health services for women Veterans with high-priority health conditions in rural and urban-isolation areas. To achieve this impact goal, we propose a Level 3 QUERI Program with three aims: 1) Using two implementation strategies (Replicating Effective Practices [REP] and Evidence-Based Quality Improvement [EBQI]), support implementation and sustainment of three evidence-based practices (EBPs) focused on preventive lifestyle and mental health care for women Veterans across 20 VA facilities (10 with REP, 10 with EBQI), several of which are rural, low-performing in women’s health care, and/or lead sites for high reliability organization. 2) Conduct a mixed methods implementation evaluation using a cluster randomized type 3 hybrid implementation-effectiveness trial design. We will compare the effectiveness of REP and EBQI in terms of: (a) improved access to and rates of engagement in virtual preventive lifestyle and mental health services and improved VA performance metrics for virtual and telehealth care delivery and related clinical outcomes for women Veterans; (b) progression along the Stages of Implementation Completion; (c) adaptation, sensemaking, and experiences of EBP implementation among multilevel stakeholders; and (d) cost and return on investment. 3) Generate implementation “playbooks” for program partners that are scalable and serve as guidance for future implementation of a broader array of evidence-based women’s health programs and policies. We will implement three EBPs: 1) Virtual Diabetes Prevention Program (DPP), an evidence-base...