Adaptations & IMpacts – Understanding Teen Pregnancy Prevention Programs (AIM-UP) Abstract: Adolescent pregnancies remain an area of marked health disparities, with significantly higher rates among Black and Latino/a populations, rural youth, and youth involved in systems. What there has been significant effort put into the initial development and testing of evidence-based teen pregnancy prevention programs (EBPs), little data exist to guide replication and adaptation to local contexts or for diverse populations. Yet most programs require some type of adaptation. The AIM-UP project combines mixed methods data from nine large-scale federal- and state-funded replication projects with over 17,000 participants from diverse locations and populations across the state of Indiana. The AIM-UP project seeks to advance our understanding of adaptation in EBPs focused on four key areas: system involvement and trauma, implementing in rural communities, diversity, equity, inclusion and justice, and the need for virtual learning approaches. Using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) as a guide, the specific aims of this proposal are: (1) to describe the frequency, characteristics and type of adaptations made when implementing EBPs with a focus on the above four key areas; (2) to quantitatively examine the effect of adaptations in these four key areas on key EBP targets, including skills, knowledge, attitudes, intentions and behaviors, using youth surveys; (3) to describe stakeholder's approaches for determining the need for adaptations for trauma/system involvement, DEIJ, rural delivery and virtual delivery, processes of adaptation, and assessment of adaptation impact; and (4) to create an adaptation toolkit using a Delphi process involving expert and community stakeholders. The AIM-UP Project team is a 10 year university-community collaboration, led by Dr. Mary Ott, and supported by Dr. Devon Hensel and Health Care Education and Training, Inc. (HCET). The team has the research and analytical experiences, collaborative history, project management skills, and program implementation expertise necessary to execute the proposed study. The AIM-UP Project will inform EBP adaptation and replication.