Abstract We propose renewal of the University of Alabama at Birmingham (UAB) health services research (HSR) T32 training grant. UAB and our training program are situated in Alabama, in the heart of the U.S. Deep South region with a disproportionate burden of disease, lagging health indicators, and deep-seated inequities. The centerpiece of the UAB Center for Outcomes and Effectiveness Research and Education (COERE) training portfolio since 2003, the UAB HSR T32 program is as important now as it has ever been. Federal and state laws, hospital closures, and limited rural healthcare providers result in an environment with formidable barriers to Agency for Healthcare Research and Quality mission-aligned priorities of making health care safer, higher quality, more accessible, equitable, and affordable. In this context, our overarching objective is to equip diverse cohorts of pre- and postdoctoral fellows with the health services research and professional skills to become change agents in the healthcare research workforce. MPD/MPI Michael Mugavero, MD, MHSc and Emily Levitan, ScD collaborate with 9 Core Faculty and 49 Participating Faculty Mentors buttressed by an $84 million extramural funding research base to deliver rigorous didactic and experiential training via the following specific aims: 1. Cultivate a dynamic, inclusive, and engaging training environment. 2. Foster the conduct of mentored research projects. 3. Train fellows in health services and outcomes research methodology and professional skills. 4. Sponsor Certificate, Master’s, and Doctoral degrees. 5. Facilitate participation in enrichment programs. 6. Evaluate program effectiveness. Numerous training program innovations are proposed, informed by systematic program evaluation with feedback from an Advisory Committee and Alumni Council. These include an immersive training experience in newly renovated physical space, increased emphasis on health equity research methods, and the addition of hands-on Career Development Workshops and Office Hours with methodologists from diverse disciplines. With this renewal, we propose continuation of 4 predoctoral and 5 postdoctoral slots, noting all slots have been filled in the history of the program, with roughly 5 applicants per available slot (20% acceptance). We are deeply committed to promoting diversity and inclusivity, with 31% of UAB HSR T32 fellow slots appointed to persons from backgrounds underrepresented in biomedical research in the current reporting period. The performance of our trainees has been outstanding, with 100% program completion, 125 fellow publications, and 6 alumni receiving extramural K awards in the current reporting period. Overall, 79% of program alumni remaining in the healthcare research workforce. Institutional commitments include newly renovated physical space housing the COERE and UAB HSR T32 training program, and funding for training program faculty and staff salaries, an additional postdoctoral slot, and training and...