TRANSCEND-Overall Overall Summary Our objective is a Clinical and Translational Research Development Program (CTR-D) that expands clinical and translational (C&T) research focused on health problems in North Dakota (ND). The name of our CTR-D, TRANSCEND, is an acronym for Translational Science Engaging North Dakota. TRANSCEND focuses on diseases prevalent in ND and their potential environmental exposures. The high prevalence of several health conditions in ND, e.g., colorectal cancer and neurodegenerative diseases like Alzheimer’s and Parkinson’s Diseases, as well as psychiatric problems such as high youth suicide rates, makes it ideal for investment in research infrastructure, as advances for problems prevalent in ND can be applied to those problems occurring elsewhere. Partner institutions in TRANSCEND are The University of North Dakota (UND,) North Dakota State University (NDSU), and Sanford Health. The Specific Aims of Transcend are to: Aim 1: Elevate the profile of C&T research throughout North Dakota Universities and clinics. Aim 2. Streamline the “road” to successful C&T research by removing roadblocks and by offering “roadside” assistance (practical research training and assistance) to investigators. Aim 3. Make tangible, positive impacts on the health of North Dakotans. We have identified significant challenges to the conduct of C&T research, including faculty with limited C&T training, difficult patient access (UNDSMHS does not own a hospital), and challenges for faculty in forming collaborations. We have developed several strategies to overcome these challenges, including support for Department Chairs and faculty to enroll in C&T training courses from Mayo Clinic, Harvard, and Stanford University. We have established collaborations with Sanford and community clinics, e.g., the Community Health Association of the Dakotas (CHAD), to improve access to patient and patient data. We have developed several collaboration methods, including the TRANSCEND portal with the names, research interests, and contact information of basic and clinical scientists interested in C&T research, and a personal research Navigator who can function as a matchmaker to establish teams of researchers. TRANSCEND will accomplish its aims with 4 scientific cores: Professional Development; Health Research (pilot studies); Community Engagement; and Research Design. A central Administrative Core supports the cores. Each of the cores is directed by experienced, extramurally-funded faculty with expertise in investigator training and mentorship. TRANSCEND innovates in many ways, including a re-entry pilot in which previously unfunded investigators “re-enter” the grant process, inclusion of Engineering faculty, and financial incentives for submitting extramural grants. Our Community Engagement and Outreach Core is highly experienced in working with indigenous/minority communities. Another innovation is our Community Physician at Large (CoPal) who aligns TRANSCEND with commun...