Alignment of Cancer services with Cancer Survivorship Standards in the American Southeast (ACCeSS-AS) This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 24-041 and as a supplement to the Atrium Health Wake Forest Baptist Comprehensive Cancer Center (AHWFBCCC) National Cancer Institute Cancer Center Support Grant (P30 CA012197, Ruben Mesa, PI). The AHWFBCCC catchment area includes 30 counties across central and western North Carolina and northwest South Carolina. It includes 4.8 million residents, about one-third racial/ethnic minority, and a significant rural footprint. This project will contribute to the broader goal of AHWFBCCC’s Community Outreach and Engagement efforts and survivorship is one of the P30’s five main strategic priorities that represents the intersection between the Cancer Center’s science and the community it serves. This NOSI calls for assessing and enhancing survivorship care in accordance with the National Standards for Survivorship Care that were established after the P30 was awarded. It will take intentional strategies to successfully implement these new standards into existing clinical care. Implementation varies greatly depending on contextual factors. Indeed, a recent overview of systematic reviews of survivorship care highlighted the importance of considering care contexts when designing the most appropriate model to improve outcomes and efficiency. Further, there is also a gap in understanding what care models are effective in diverse populations (e.g., by race/ethnicity, geographic location). We propose conducting an adapted action planning process consisting of two overarching phases with a three level structure including quantitative and qualitative analysis; micro (e.g. patients), meso (e.g. clinics), and macro (e.g. organizational). For phase one, we will evaluate the extent to which survivorship care programs in a multidimensional health care system align with recently developed National Standards for Survivorship Care through a mixed-methods approach. We will review existing data, engage a Survivorship Insights Council, administer an electronic survey across all practices, and conduct clinic observations and stakeholder interviews with four representative practices. For the second phase, we aim to expand efforts to contextualize current cancer survivorship care by identifying barriers, gap areas, and facilitators to inform future adaptation and implementation of optimized survivorship care. This will include analyzing the new qualitative and quantitative data, convening stakeholders to prioritize next steps, seeking advice from the existing AHWFBCCC Community Advisory Board, summarizing results based on the shared goals of the sites, and developing an implementation planning toolkit needed for expanding this systematic action planning process across more clinics. Establishing a systematic process for assessing and improving accessible survivorship care...