PROJECT SUMMARY – PROJECT 3 The goal of the COllaboration for EQuity in Uterine Leiomyomas (COEQUaL) Project 3 is to develop innovative technology to identify women with uterine fibroids early for intervention/prevention and to predict the re-intervention rate after therapeutic options, while ensuring the implementation of such technology is acceptable to women with UF. The specific aims of Project 3 are: 1) to develop, validate, and assess the portability of EHR risk prediction models for incident symptomatic fibroids, 2) to characterize patients for whom genetic information improves upon an EHR-based fibroid prediction risk model. 3) to identify factors associated with hysterectomy and the effect of uterine-conserving therapies that allow for the prevention of hysterectomy. Stakeholder input will be sought throughout the project to assess the acceptability of implementation of EHR- based technology including genetic data and risk prediction models. Given the major health and healthcare disparities seen in women with fibroids, and especially Black/African American women with fibroids, the evaluation and decision-making for therapy should be standardized, equitable, and accessible to all women. The findings of this COEQUaL project will change the clinical paradigm for clinical care by creating tools for healthcare providers systems to empower personalized and evidence-based decision making for women with fibroids.