PROJECT SUMMARY The Delaware Sickle Cell Disease (SCD) COBRE is a multidisciplinary center of biomedical research excellence with a thematic focus on translational, clinical and psychosocial research in sickle cell disease. Building on a biomedical and clinical research infrastructure developed through COBRE Phase 1 funding, and the successful recruitment of several promising early career investigators, the DE SCD COBRE is submitting a competitive renewal application to continue capacity-building and innovative research. In Phase 1, the DE SCD COBRE contributed to more than $13 million in new funding in Delaware. Integration of the DE SCD COBRE within the Delaware IDeA network continues to be integral to both the successful recruitment and training of early career investigators, as well as pilot funding. In this Phase 2 COBRE submission, the DE SCD COBRE presents a new mentoring model, a new pilot funding program, a new Clinical Research and Data Informatics Core and four new target investigators. Each of these new additions builds on success in Phase 1 and is responsive to areas of strength and growth. Additionally, we developing a multidisciplinary and systematic approach to study the influence of stigma and racism within communities and the healthcare system on the efficacy of both routine health maintenance and targeted interventions in patients with SCD. We will evaluate biomarkers for severe SCD co-morbidities (Project 4), engage our patients and community to take stock of barriers to routine care (Project 1, 2, and 3) and explore tools to improve self-efficacy among health care providers (Project 1) and patients (Project 1, 2, and 3), while simultaneously confronting how racism impacts the health of children and young adults (Project 1, 2, and 3). Central to all aspects of the Delaware Sickle Cell Research Program is the overarching Center hypothesis that effective management of a common, congenital, multi-system disease requires comprehensive investigations spanning the biological, medical, psychological, and societal factors that impact both the severity of the disease and the efficacy of interventions.