CADRE seeks renewed COIN funding to continue to address an HSR&D research emphasis in health care access and equity while focusing on Secretary Shulkin’s priorities to provide greater choice for Veterans, focus resources more efficiently, and improve timeliness of services. One-third of all enrolled Veterans are considered rural. Rural Veterans face unique barriers to care related to shortages of both VHA and community providers in rural areas, long distances to existing providers, poor availability of broadband internet to support digital interventions and high rates of poverty. VISN 23 has the highest proportion of rural Veterans, therefore, CADRE investigators seek to understand access barriers from the rural Veteran’s perspective and develop interventions that enhance existing VHA and community resources in rural settings. In addition, CADRE aims to build upon our existing expertise, established operational partnerships and long-term research priorities through prioritizing five overarching Center goals that align with our focused areas of research and emerging priorities: GOAL 1: Improve access to high quality care for rural Veterans through innovative applications of telehealth in specialty care, community care, and dual use. (Focused Area #1) GOAL 2: Develop and evaluate interventions targeting the multidrug-resistant organism (MDRO) crisis. (Focused Area #2) GOAL 3: Expand our efforts in developing innovative health services research in three emerging areas: (1) women’s health, (2) epidemic opioid use and substance use disorders, and (3) cardiovascular outcomes. GOAL 4: Continue the Center’s success in supporting mentored career-development. GOAL 5: Promote Veteran engagement with recognition that Veterans are experts on Veteran experience. The proposed focused areas, additional emerging areas and related goals build upon CADRE investigators’ strengths and leverage established partnerships with the Office of Rural Health, Office of Connected Care, Office of Specialty Care, MDRO Prevention Office, VISN 23, Pharmacy Benefits Management Services, Iowa City VA Health Care System, the University of Iowa and the Centers for Disease Control & Prevention (CDC). CADRE investigators have had significant recent accomplishments including: (1) designing and evaluating 2 of the 5 Office of Rural Health’s Promising Practices; (2) leading a field-based meeting with 37 experts to establish the national research priorities for MDRO in VA; (3) serving as Senior Reproductive Endocrinologist and Fertility expert to Women’s Health Service, (4) the making key recommendations to VA leadership regarding community care, dual use, MDROs, telehealth, and women’s health; and (5) publishing articles that move their respective fields forward. CADRE will continue to be led by two accomplished scientists, Eli Perencevich and Heather Reisinger, who’s leadership in MDRO prevention and rural access provide experience and the necessary connections with VA operations to conti...