ELEVATE Training Integration Core Abstract Substance use disorder (SUD) is by far the leading cause of pregnancy-associated death in our community, and it disproportionately affects American Indian and Alaska Native (AI/AN) and rural populations. Successful response to this maternal death crisis demands community partnerships and transdisciplinary collaborations in both clinical and research efforts. To achieve this paradigm shift, early-stage investigators (ESIs) from diverse backgrounds must be trained to recognize SUD as a condition that lies at the intersection of bio-behavioral, sociopolitical, and public health factors. We use an expansive definition of ESI to include investigators along career pathways from students to junior faculty. The ELEVATE Training Integration Core will use a combination of academic institutional resources and community partnerships to create opportunities for ESIs. This diverse group of trainees will serve as a pool for our Training Program capstone: the ELEVATE scholar, a mentored faculty research position with 75% FTE support from the University of Utah (U of U) Vice-President for Research. The U of U academic resources include formalized research training opportunities available through the Substance Use & Pregnancy – Recovery, Addiction, Dependence (SUPeRAD) Clinic; the Vice President’s Clinical and Translational Research Scholar Program (VPCAT), the Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA); and Utah Center for Clinical and Translational Science Institute (CTSI). The community partnerships include Utah Support Advocates for Recovery Awareness (USARA) and collaborators from the Sacred Circle Clinic. Consistent with the ELEVATE Center’s focus on dissemination and implementation science, the Center supported ELEVATE Scholar will enroll in the Mountain States Community-Engaged Dissemination and Implementation Science Training Institute. All ELEVATE Center investigators will serve as research mentors. David Turok, MD will lead the Program, working in collaboration with Jasmin E. Charles, PA-C, co-founder and clinical director of SUPeRAD who will coordinate research opportunities for ESIs across all Center projects. The ELEVATE research projects provide a foundation and focus for aspiring researchers to 1) support the development of a culturally-integrated perinatal SUD intervention for urban Native mothers by adapting the successful SUPeRAD model, 2) help develop and execute a training package to mitigate bias and stigma against individuals with SUD, and 3) to conduct and evaluate informant interviews in collaboration with the Utah Maternal Mortality Review Committee in order to understand the family, systems and community-level contributors and the role of discrimination in pregnancy related death. The ELEVATE Training Integration Core will grow a cadre of future leaders in Utah with the skillsets needed to identify and investigate the most functional solutions to the complicat...