This cost extension for the IGNITE network was requested by NHGRI program office in order to complete the activities for the network trials GUARDD and ADOPT-PGX as well as the follow-on network activities. The delays in the trials for GUARDD and ADOPT-PGX were multifactorial and were greatly influenced by the COVID pandemic. In addition, some trial specific challenges led to delays: the length of time to develop protocols and processes, the complexity of the sIRB and reliance agreements among so many sites, procedural differences at each site, adding additional recruiting health systems mid-way, and the need to increase enrollment targets to account for adjustments to the power analysis. In this second year of the cost extension we will be completing study closeout activities, secondary analyses for papers, and continuing to participate in the network.