Project Summary/Abstract My career focus is research and educational efforts to reduce early cardiovascular disease (CVD) risk factors. Obesity, diabetes, and underlying insulin resistance (IR) are major contributors to CVD, accelerated by the current pediatric obesity epidemic. Unique factors in youth with type 2 diabetes (T2D) lead to early insulin dependence and progression of co-morbidities that accelerate CVD and mortality, and typical adult T2D treatments are ineffective in youth. The mechanism of IR in T1D is also unclear, limiting our ability to reduce CVD risk in T1D. Moreover, current CV-assessment tools are often too invasive for youth. My prior research training, initial leadership experiences and collaborations with cardiology, bioengineering, and radiology provide the skills and combined expertise to address these critical voids. An NHLBI K24 grant will train me to better provide mentorship in high-impact POR to CVD-focused physician-scientists of exceptional potential and nurture a diverse pipeline of new investigators. My career goals are to: 1) Better understand early precursors of CVD in the underserved population of youth with obesity/diabetes 2) Develop non-invasive approaches to CVD risk-assessment tolerable to youth 3) Develop new medical and/or surgical treatments to reduce CVD risk in youth and 4) Learn how to best engage, motivate and train a diverse set of emerging researchers in cutting- edge POR. Support as a K24 scholar will provide dedicated time to benefit from the exceptional POR mentoring and leadership training resources of our campus and beyond, and focus on these goals. My K24 application includes an overview of: 1) My skills, record and dedication to mentoring in POR; 2) A strategy to reduce administrative/clinical obligations and focus on mentoring; 3) An impactful, cutting-edge K24 POR proposal with numerous opportunities for trainees; 4) A strategy for integrating expert collaborators as a K24 Advisory Committee to deliver superior and cohesive training, mentoring and oversight of junior colleagues and to assure a pipeline of future trainees; 5) Evidence of a robust pool of protected early career POR investigators to benefit from K24 support; 6) A timeline for training in responsible conduct of research; 7) Evidence of the collaborator, institutional and environmental support underlying my POR program and for the K24 proposal. My Aims as an NHLBI K24 Scholar are to: 1) Strengthen mentoring of a diverse set of early career investigators to create a pipeline of well-trained physician-scientists focused on CVD POR. Rationale: The proposed training plan offers exceptional support, environment and expertise for creating a POR career in CVD prevention. I will integrate my current mentoring skills with those gained from the K24, to deliver the highest quality mentorship. 2). Build upon my CVD risk-reduction POR in youth-onset obesity/diabetes. Rationale: Given K24 support, I am positioned to enhance the quality...