Project Summary/Abstract This proposed Diversity Research Supplement aims to extend the scientific impact of the Mississippi Environmental Influences on Child Health Outcomes (ECHO) IDeA States Pediatric Clinical Trials Network (ISPCTN) Cycle 2 parent award by identifying barriers and facilitators to pediatric clinical trials, increasing our understanding of the impact of the COVID-19 pandemic on families in Mississippi, and support a promising diverse early career investigator, Tre Gissandaner, MA, who will contribute to the diversity of the pediatric clinical trials and NIH workforces. The mentee’s immediate career development goals are to: 1) increase knowledge related to pediatric clinical trials research by engaging in ECHO ISPCTN sponsored trainings and meetings, local site activities, working groups, mentoring, and professional development activities, 2) expand manuscript and grant writing skills by publishing multiple first author manuscripts and disseminating findings from the research plan at national conferences, and 3) enhance child clinical psychology skills by participating in advanced trainings that will inform the development of an ECHO ISPCTN clinical trials concept proposal and K award grant submission. To achieve these training goals, the two-year research plan will examine data from a state wide telephone survey, which included 600 caregivers and focus on the research following aims: 1) examine barriers and facilitators to pediatric clinical trials identified by caregivers of youth with ECHO related chronic medical conditions to develop targeted strategies to improve trial designs at our site and in the larger ECHO ISPCTN, and 2) compare impact of COVID-19 pandemic on mental health functioning in families from rural and urban communities. The proposed diversity research supplement and training plan extends the parent award’s scientific impact by generating new knowledge that will inform current and future pediatric clinical trial design related to enrollment, participation, retention, and completion at our local and other ECHO ISPCTN sites. Children have historically been under-represented in clinical trials research and those from rural and underserved communities experience additional disparities related to access to clinical trials research. In order to continue to improve the health of all children, there is a need to diversify the pediatric clinical trial and NIH workforce, as well as better understand barriers and facilitators regarding families participating in pediatric clinical trials research, which are the focus of this diversity research supplement.