PROJECT SUMMARY A systematic approach to fostering diversity and inclusion in clinical research Our research expands on the aims of the South Dakota Pediatric Clinical Trials Network (SoDakPCTN) to build research infrastructure in a community-based setting. We will conduct a systematic approach to the evaluation of current diversity and inclusion efforts via literature review, connecting with key stakeholders via formal interviews, and identification of barriers. In essence, we will collect data from stakeholders within the Avera Health system and community leaders and members on factors that may contribute to increase participation of diverse individuals in clinical trials conducted in the Avera Health footprint. From there, the trans- theoretical model of behavior change will help formulate means through which barriers can be overcome and an increase in diversity and inclusion in clinical research achieved. This supplement is responsive to the National Institutes of Health call to promote diversity and inclusion in clinical trials, especially in rural settings The outcomes of this proposed analyses are the development of relationships with key stakeholders and community members, and a drafted model (toolkit) that helps other organizations in the mid-west begin to increase their inclusion efforts when it comes to representation of racial and ethnic minorities in community and clinical research. We will achieve these outcomes via the following aims: 1) Successfully complete didactic coursework in statistical analysis and training related to setting up clinical trial operations. 2) Explore the barriers and facilitators to increasing diversity in clinical trials within Avera’s rural healthcare environment. 3) Using a transtheoretical model of behavior change, identify solution-oriented strategies to enhance diversity in clinical trial participation within the Avera’s healthcare environment.