PROJECT SUMMARY Children who enter school ready to learn are more likely to succeed academically. Yet, low-income children often enter school behind their more affluent peers. The growing population of Latino children experience economic and cultural barriers to school readiness (SR). The primary care clinic represents an opportunity to augment the fractured early childhood education (ECE) system, as pediatricians have trusted, repeated relationships with children and families. In prior work Latino families of recent kindergarteners identified specific interventions that could be adapted to their needs in the pediatric clinic including increased knowledge through skills checklists and text messages, connection to preschool through automatic referrals and parent empowerment through coaching with parent-child dyads. My long-term goal is to be an independent physician-scientist and leader in development and implementation of SR supports for Latino children. This K08 grant will provide mentorship and skill development in learning health systems to become a school readiness expert and prepare for an early career award. My career development plan includes specific training goals: 1) expertise in mobile health interventions, 2) advanced implementation science, 3) clinical trial design for multi-component interventions, and 4) history and educational culture of immigrant Latinos in the US. The research objective of this K08 Career Development Proposal is to refine and pilot test a package of parent preferred pediatric clinic-based SR interventions that specifically target the SR needs and desires of Latino families. The study premise is that the pediatric clinic is a trusted, acceptable and feasible setting to identify and address SR needs. Specific Aims: (1) qualitatively determine acceptability, perceived benefits and implementation for a package of primary-care based SR interventions through interviews with pediatric providers and early childhood educators (ECE) (n=20), (2) engage a stakeholder panel to prioritize usable and acceptable SR interventions, create a SR program for the clinical setting, and develop an implementation strategy for pilot testing and 3) pilot the SR intervention program with parents of Spanish speaking first-born 2- 3-year-olds to determine feasibility and acceptability in the primary care clinic (n=50).