PROJECT SUMMARY/ABSTRACT Every year, 50,000 preterm infants are diagnosed with chronic lung disease (CLD). CLD is associated with reduced lung function and morbidity that persists into adulthood, with glaring racial disparities. Black preterm infants with CLD have higher rates of respiratory symptoms, medication use, emergency department visits, and readmissions in the first year of life, although White preterm infants are more likely to be diagnosed with CLD at birth. Few studies with Black preterm infants have focused on this critical period of the lifecourse after hospital discharge. Patient and family engagement interventions can promote equity and improve health outcomes by centering on patients' lived experiences. This may be especially true for Black preterm infants with CLD whose engagement in care is impacted by complex medical needs, social determinants, and parental mental health and wellbeing. Guided by an inclusive and multidisciplinary advisory board co-led by Black parents, this proposal will provide novel insights into the hospital to home transition for Black preterm infants with CLD. It will also address a critical need for health equity interventions in pediatrics. Aim 1 is to characterize profiles of preterm infants with CLD by medical needs and social determinants and identify profiles associated with the highest risk of respiratory morbidity. Aim 2 is to describe the lived experience of parents of Black preterm infants with CLD in the first year of life. Aim 3 is to develop and evaluate the feasibility and acceptability of a pediatric-adapted collaborative goal setting (P-CGS) tool piloted with parents of Black preterm infants with CLD during a primary care visit and explore preliminary child and parent outcomes. This K23 proposal addresses two critically important NHLBI priority areas: 1) pediatric lung health disparities, and 2) the transition from hospital to home for preterm infants with CLD. It will also provide the applicant, Dr. Brandon Smith, MD, MPH, the opportunity to become an independent clinician investigator with expertise in parent engagement interventions in primary care to advance health equity. The proposed research and career development plan will support Dr. Smith's four training objectives: 1) acquire skills in advanced statistical methods; 2) gain expertise in designing and leading qualitative research; 3) attain skills in the development and testing of interventions in pediatric primary care; and 4) obtain in-depth understanding of patient engagement theory and practice to promote health equity with emphasis on local expertise. Dr. Smith will take advantage of a committed and multidisciplinary mentorship team and strong training environment at the Johns Hopkins Medical Institutions to launch his independent career. The results of this study will provide preliminary data for a future R01 application to test the efficacy of the P-CGS tool in reducing lung health disparities for Black preterm infants with...