Puerto Rico Collaborative Advancement of Research, Innovations, Best Practices and Equity for Children, Youth and Families (PR-CARIBE) employs a Collective Impact approach to co-create a structural intervention research strategy with equity focus. Poverty is the structural barrier fueling health disparities in PR. Kids Counts Puerto Rico1 found that 57% of children and youth live under poverty levels with a median household income of $21,492. Positions PR as the jurisdiction with the highest economic and social inequality for children and youth in the US. Our main challenge is to reduce child poverty, increase mobility opportunities that foster equity, wellness, and healthy development. Intervening in the social context providing additional resources for children and youth from less privileged socioeconomic status to attain their full health potential is paramount. Collective Impact provides PR-CARIBE’s HERA tools to launch structural changes through policies, practices, and programs impacting selected health outcomes. PR is on the threshold of structural change. At the policy and practice level between 2019-2022 various stakeholder groups in PR developed relevant needs assessments, strategic plans and laws providing data driven roadmaps to scale-up strategies in a coordinated and sustainable way. PR-CARIBE overall approach is guided by the National Academies of Sciences3 conceptual model to leverage opportunities advancing health equity across the life span which illustrates complex sociocultural environment shaping development at the individual level and opportunities to improve individual health, developmental outcomes, population health, well-being, and health equity. PR-CARIBE innovates advancing methods to design, implement, and evaluate structural interventions transferable to resource-poor communities. 1 of 1