PROJECT SUMMARY/ABSTRACT Adolescents and young adults (AYA) with Type 1 Diabetes (T1D) experience a peak in risk for poor glycemic control during the transition from pediatric- to adult-focused care, which in turn increases their risk for short- and long-term diabetes complications. These risks peak in part due to fragmentation of care and a shift in disease management responsibilities from being parent-directed to self-directed. AYA need support from their parents/caregivers and health care team in building knowledge regarding their own health and developing necessary skills for independently making health decisions and using health care, but many families lack an understanding of how to facilitate the gradual transfer of skills from parent to child and/or the motivation to do so in a timely and effective way. This award for Lauren Wisk, Ph.D., a pediatric health services researcher, will target this important area by building on prior research and skills supported by a mentored career development award (K01). In Aim 1, Dr. Wisk will develop summaries of population data and use qualitative methods to engage parents of AYA with T1D in evaluating those summaries for salience and acceptability for use in a family-centered, behavioral intervention. Dr. Wisk will incorporate her new skills in behavioral science and health communication as the foundation of this family-centered intervention design to improve parents' motivation to assist their child in developing transition preparation skills. In Aim 2, she will apply her training in implementation and improvement science in order to implement the intervention, assess its effectiveness for motivating adoption of evidence-based strategies for teaching transition preparation skills. Results from this study will perfectly supplement Dr. Wisk's K01 research to develop and implement a behavioral intervention trial to improve transition preparation for AYA with T1D in order to form the basis of a longitudinal, family- centered trial to be proposed in an R01 application. This award will further support Dr. Wisk as she seeks to become an independent investigator with comprehensive expertise in designing, implementing and disseminating interventions for AYA with T1D and their families during their health care and life-course transitions. This award builds logically on her career development award and accompanying training activities, and will demonstrate her ability to successfully apply her new skills on this related project. Dr. Wisk is uniquely positioned to use this award and the resources provided by her K01 to launch an independently-funded research career.