Project Summary/Abstract Children's community violence exposure (CVE) is a public health crisis, and racial and ethnic disparities are well-documented. As a source of toxic stress, CVE can lead to poor mental and physical health outcomes, disproportionately affects children in racially and economically segregated communities, and perpetuates health disparities. Concentrated neighborhood disadvantage and limited access to youth services (in combination with family and individual factors) influence and exacerbate disparities in CVE11-12. Over the past 7 years we have developed a novel, interdisciplinary, pediatric healthcare model that provides psychological and psychiatric trauma-informed assessment, social work-focused case management, and treatment planning across a short period (3-sessions) within a general medical center. Our target population are pediatric patients and their families who are affected by community violence, whether or not they have been injured. The University of Chicago Medicine REACT (Recovery & Empowerment After Community Trauma) Clinic4 is a trauma-informed intervention focused on healing, rather than risk, to empower minoritized and systematically oppressed CVE urban families. The REACT Clinic is located on Chicago’s South Side in one of the most racially and economically segregated cities in the US.5-7 The REACT Clinic is innovative because it is the only SAMHSA funded clinic in the US that provides Black youth, within the Chicago metropolitan area, with free, accessible, high-quality, anti-racist, structurally and culturally responsive, strengths-based, interdisciplinary care to specifically address effects of community violence and trauma. To date, the impact of the REACT program has not been systematically evaluated. Both pilot data from REACT families and a robust prior literature8-10 suggest that the mechanisms most associated with mental healthcare utilization (MHCU) are mental health stigma, healthcare distrust, and mental health literacy. Thus, the objective of this two-year proposal is to systematically test whether the REACT Clinic model is related to changes in the these three mechanisms after completion of services and at 3-month follow- up. The study proposes a longitudinal, within-person, mixed-method approach to collect and analyze data from a sample of 48 Black youth aged 12 -18 and their primary caregivers who have received REACT service following CVE. The study has three goals: (1) employ a mixed methods design to examine acceptability, feasibility, and adherence to the REACT Clinic model; (2) examine the impact of the REACT Clinic on proximal outcomes (MHS, MHL, HCD) as reported by caregivers (n=48), at baseline, post-intervention, and at 3 month follow-up; and 3) establish initial estimates of MHCU (distal outcome) and explore whether metrics of acceptability and adherence and/or changes in proximal outcomes are associated with MHCU at 3-month follow-up.