The primary mission of the Oklahoma Shared Clinical and Translational Resources (OSCTR) is to improve health by catalyzing clinical and translational research (CTR) that addresses the top health concerns experienced in the state. The OSCTR integrates health professionals, investigators, and scientific resources at more than 30 public, private, and tribal partners statewide to fulfill its mission. Several features make Oklahoma an ideal setting to continue and expand these efforts, including high rates of chronic diseases and large rural and tribal populations where improved outcomes may serve as models across IDeA states. Oklahomans have the sixth lowest life expectancy in the US, with widening disparities for American Indians and rural populations leading to early mortality. Cancer, diabetes, cardiovascular disease, arthritis, and autoimmunity are top causes of enhanced morbidity or disability and are exacerbated by high rates of tobacco and other substance abuse and low rates of routine health screening and healthy life choices. Research on the health priorities and health equity of our tribal and other underserved populations has been fostered by strong relationships between research institutions and tribal nations and rural communities. The OSCTR has helped build a growing and diverse cadre of investigators who have launched independent CTR careers and is broadly supported by institutional leaders committed to CTR and improving Oklahomans’ health. The OSCTR houses a highly productive Clinical Resources Core with a CAP-certified biorepository and cutting-edge resources for clinical data research. Concurrent with these strengths, the OSCTR has leveraged partnerships to build networks for practice-based research to help speed the adoption of evidence-based practices in patient care. Despite our successes, the sustainability of CTR research in Oklahoma and its impact on public health are limited by ongoing needs for infrastructure support and clinical research investigators. To support rural and tribal health equity, the OSCTR will assist tribal health systems in building CTR infrastructure, foster interactions via the Tribal Engagement Unit, and expand research with community organizations to address social determinants of health and increase opportunities for clinical trial participation. We will continue to support the development of junior investigators from many disciplines by providing training, mentoring, pilot grants, biostatistics/epidemiology expertise, access to patient samples and clinical data, study recruitment and regulatory assistance, and comprehensive online resources. We will engage health professionals, communi- ties, and patients in high-priority CTR through an online portal and existing networks of community-oriented health improvement organizations. We will continue work with Oklahoma IDeA programs and the national IDeA-CTR network to develop and share effective infrastructure and increase opportunities for Oklahomans to pa...