Modified Project Summary Section This 5-year effort titled “Leveraging a Regional Clinical Practice Research Network in Imperial County, California (Imperial County Clinical Research Network)” seeks to advance clinical research by establishing the personnel and systems (policies and procedures) infrastructure to support research within a healthcare system that serves a rural community in Southern California. It accomplishes this by bringing together three primary organizations and their respective leaders to develop a disease-agnostic research agenda consistent with the needs of patients, clinicians and organizational stakeholders. Infrastructure will be developed to support both observational (e.g., cohort studies; secondary analyses using electronic medical record [EMR] data) and intervention (from efficacy to effectiveness trials) research. During the UG3 phase, we propose to develop the research infrastructure to support the implementation of a pragmatic trial as this provides the strongest possible infrastructure for supporting PP21. The UG3 phase also will advance data sharing activities including identifying a set of common data elements across Network sites, and developing and testing protocols and systems for sharing data, including EMR data from multiple systems. During the UH3 phase (Y3-5), both PPs will be launched following final approval from the Multidisciplinary Research Council and the SDSU IRB committee. PP1 proposes to test a provider intervention to increase prescribing and patient use of continuous glucose monitoring. The UH3 phase will continue to advance data sharing through the development of protocols and systems for data verification, data harmonization, and meaningful interpretation of. The proposed timeline plans for data sharing and harmonization to occur with the PPs as early as possible, and with sufficient time at the end to complete final follow-up data collection from participants, and data submitted to the Coordinating Center in Y5. All of these efforts will be guided by the involvement of a Patient Advisory Committee (5 members), a Clinician Advisory Committee (15 clinical representatives), and a Community Stakeholder Committee (12 members). The ultimate goal of this effort is to identify feasible, sustainable, and translatable approaches to promote health and wellbeing in rural communities.