PROJECT SUMMARY/ABSTRACT Hyperlipidemia (HLD) is a major contributor to atherosclerotic cardiovascular disease (ASCVD), the leading cause of US mortality and morbidity. Nearly 30% of Emergency Department (ED) patients with chest pain have undiagnosed and/or unmanaged HLD, putting them at an increased risk of ASCVD. Although safe and effective HLD treatments exist, the ED traditionally focuses on acute care and does not offer preventive cardiovascular care services or treatment for HLD. This represents a large, missed opportunity to improve cardiovascular health for the millions of Americans evaluated in the ED each year for chest pain who are not receiving appropriate guideline-directed preventive care in the outpatient setting. The overarching research goals of this study are to determine the efficacy of a novel, protocolized, ED-based preventive care intervention for HLD known as EMERALD (Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders) in lowering cholesterol while also informing our understanding of patient adherence and implementation determinants of ED-based preventive cardiovascular care. To accomplish these goals, I worked with my mentoring team to design a career development plan that blends multidisciplinary research training with an innovative research proposal. Aim 1 will use a randomized, controlled, single center, parallel group trial of 130 ED patients to test the efficacy of EMERALD vs. usual care in lowering cholesterol. Aim 2 will rely on mixed methods to identify patient adherence facilitators and barriers as well as implementation determinants for Emergency Medicine providers. To successfully accomplish these Specific Aims, I will capitalize on the outstanding research environment at the Wake Forest University School of Medicine and my engaged transdisciplinary mentorship team of senior scientists. With support from my mentoring team, I will complete a robust career development program that will provide me with the necessary