ABSTRACT The Primary Care Rural and Frontier Clinical Trials Innovation Center (PRaCTICe) Network Research Hub (NRH) is a partnership between the Oregon Rural Practice-based Research Network (ORPRN), the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region Practice and Research Network (WPRN) and their institutions’ Clinical and Translational Science Award (CTSA) programs. The PRaCTICe team has over two decades of experience partnering with 308 clinics and communities in rural settings on research, education, and technical assistance projects – including nearly 100 clinical research studies since 2019 (65 completed, 33 active). While 29% (932/3160) of the census tracks across the six Western states are in rural designated locations (RUCA 4-10), 76% of the priority year 1 clinical sites (N=29 clinics) we partner with in PRaCTICe are rural. PRaCTICe will be co-led by the Directors of ORPRN and WPRN, strengthen established partnerships with clinical sites in rural settings, and consists of four cores: Community Engagement, Recruitment & Trials, Data Coordination, and Communications & Dissemination. Together these cores will work to successfully accrue participants for existing primary care-based NIH studies and codesign future studies relevant to primary care clinics and communities in rural settings. Notably, our approach builds on established processes to support study codesign and infrastructure that extends beyond individual projects. PRaCTICe is anticipated to have a substantial positive impact in adopting and implementing research advances into clinical care, growing primary care engagement, and advancing health for all communities.