PROJECT SUMMARY/ABSTRACT The last decade has seen significant advances in stroke prevention, treatment, rehab and recovery. Yet, more externally valid effectiveness trials with diverse populations are critical. The NIH Stroke Trials Network (Stroke Net) was founded with the purpose of addressing inefficiencies with trial start-up, conduction and the high cost associated with lengthy processes. The use of a single IRB, standardized, non-negotiable contracts and use of a single electronic data capture system (webDCU) were implemented in order to reduce start-up times, costs and improve data quality. Inclusion of centers across the US aims to increase participant numbers and diversity. University of Utah Health (UUH) is a highly successful NIH Stroke Net Regional Coordinating Center (RCC). Utah (UT) Stroke Net is centered in the Mountain West, a 5-state region covering 10% of the U.S. landmass with 25 million inhabitants of increasing diversity. UT Stroke Net includes 11 Clinical Performing Sites (CPS), 9 adult and 2 pediatric, in Utah, Colorado, Arizona, and Montana, with a 12th site pending activation in Idaho. In the next funding period, UT Stroke Net will continue supporting and investing in its network of geographically dispersed sites and provide the diverse patients of the Mountain West access to NIH-funded stroke trials in prevention, treatment, and recovery- including under-represented minority patients and those living far from academic medical centers. UT Stroke Net will utilize innovative recruitment and retention methods coupled with the development of tools that ensure equity of access to clinical trial for all patients by capitalizing on existing tele stroke and tele neurology networks as well as deep CTSI recruitment resources. UT Stroke Net will also facilitate multi- disciplinary collaborations of local clinical and translational stroke experts in order to propose innovative trials to NINDS and the Network. UT Stroke Net will foster the education and career development of post-doctoral clinical and translational scientists through a focused, individualized training program that includes experiential learning, a mentored research project, targeted methodological training and optional courses tailored to the individual trainee. By achieving these goals, UT Stroke Net will contribute to the continued development of the national network, advancement of stroke research, and, ultimately, an improvement of stroke care for all persons in the Mountain West.