PROJECT SUMMARY/ABSTRACT Premature deaths due to cardiovascular disease (CVD) are increasing among American Indian women. Using a collaborative intervention planning approach that blends community-based participatory research (CBPR) principles and Intervention Mapping, we will implement a 3-year clinical trial planning project to adapt and investigate the feasibility, acceptability, and initial efficacy of a multi-component cardiovascular health promotion pilot intervention for American Indian women living in the southeast. First, we will adapt Mind Your Heart – an intervention with cardiovascular health education, mindfulness self-regulation, and coping skills training – culturally through qualitative formative research involving Talking Circles and Intervention Mapping with American Indian women ages 18-50 at risk for CVD, tribal citizens, and American Indian healthcare providers and traditional healers. Second, we will conduct a randomized controlled pilot study to examine feasibility, acceptability, and initial efficacy of the adapted Mind Your Heart intervention in American Indian women at risk for CVD. Third, we will refine the study infrastructure and intervention, obtain tribal and institutional review board approval, modify recruitment and retention strategies, develop a Clinical Trials Protocol, develop a Manual of Operations, and refine data collection and management procedures. Accomplishing these aims would provide the foundation for a future R01 clinical trial that directly aligns with the National Heart, Lung, and Blood Institute's scientific focus area of promoting cardiovascular health and preventing CVD across the lifespan. Preliminary evidence on the acceptability and feasibility of the adapted Mind Your Heart intervention for American Indian women would support the design and execution of a future R01 clinical trial to evaluate its efficacy. Our long- term goal is to develop a sustainable cardiovascular health program that promotes positive psychological well- being in American Indian women to prevent premature mortality from CVD.