Project Summary/Abstract As the leading cause of death and disability in the United States, cardiovascular disease has benefitted from immense research investments to improve the care of afflicted patients. However, the application of this knowledge in routine clinical practice has been variable and the evaluation of more patient-centered outcomes, including patients’ symptoms, function and quality of life, are desperately needed. Not only do these knowledge gaps limit the potential for US healthcare to improve, but evolving changes in reimbursement from a volume- to value-based payment models have created an unparalleled demand for cardiovascular outcomes researchers. This renewal application seeks to continue a highly successful program for training post-doctoral scholars to independently perform clinically-oriented outcomes research. It extends and improves the University of Missouri- Kansas City (UMKC)’s outcomes research training program, which is unique in the Midwest and serves as a central unifying research program for our region. The 2-year training program has 3 synergistic components: 1) a basic foundation of in clinical research (including a Masters degree in bioinformatics with a clinical research emphasis), 2) specialized skills for outcomes research coupled with academic ‘survival skills’ (our outcomes- based core curriculum), and 3) hands-on research. Hallmarks of the research experiences include multi- disciplinary group mentorship, individualized mentorship to meet each trainee’s needs; access to numerous existing data, as well as clinical populations for primary data collection and implementation; training in entrepreneurship; and highly experienced statistical support. Enhancements planned for the existing program include 1) a more robust collaboration with the University of Missouri system, which is investing in the NextGen Precision Medicine institute and for which our program serves as the central pillar for precision healthcare delivery; 2) increased engagement in clinical trial design and execution; and 3) access to a new community collaboration of 19 regional hospitals innovating healthcare delivery to improve its value (www.kcqvic.org) for deeper exposure to implementation research. Administering the program will be an experienced program director, supported by well-qualified associate and assistant directors and mentors with expertise in economics and decision analysis; large database analysis; bioinformatics; qualitative and implementation research; study design, methodology and statistics; patient and clinician behavior change; community-based participatory research; entrepreneurship; shared medical decision-making and patient-centered research; multi-disciplinary cardiovascular research; disparities research; and risk models and creation of clinical tools, as well as an advisory committee of national leaders. Collectively, our committed team will provide a formal training, mentorship and evaluation program to conti...