PROJECT SUMMARY In order to improve the health and wellbeing of our nation’s children, it is essential to transform pediatric health care to address the complex social ecological factors that persistently hamper access to child health and contribute to pervasive health inequities in the United States. Transforming the delivery of pediatric health care requires robust programs of healthcare delivery research, using innovative stakeholder-engaged approaches to ensure the development of acceptable, feasible, effective interventions ready for equitable implementation. The overall goal of this Center of Biomedical Research Excellence (COBRE) is to strengthen pediatric healthcare delivery research infrastructure in Delaware, specifically at the Alfred I. duPont Hospital for Children. Consistent with this goal, we will establish a thematic, multidisciplinary health research system – The REACH (Research Expanding Access to Child Health) Center – rooted in the principles and methods of pediatric healthcare delivery science, bridging our biomedical research and health care systems, and focused on ensuring equitable access to high quality pediatric health care for all. With strong scientific leadership and institutional commitment, the REACH Center will create resources and provide mentoring to effectively accomplish three aims: 1) Expand innovative programs of stakeholder-engaged intervention-focused research using advances in technology to counter negative social ecological focuses and improve child health; 2) Enhance existing expertise and expand research infrastructure through core resources supportive of health equity research for children; and, 3) Establish a critical mass of independent multidisciplinary investigators to sustain a COBRE expanding access to child health. Two outstanding junior investigators who are ideally poised for achieving independent NIH funding propose initial research projects. Each focuses on refining and evaluating technology-enabled interventions to improve equity in child health - the first for children with obesity in rural Delaware and the second for families with a prenatal diagnosis of congenital heart disease. Three Administrative Core programs: Project Funding, Mentorship, and Research Management will support the conduct of these and future REACH Center-funded projects across the five years of the COBRE1 to increase and sustain pediatric health care research in Delaware. Two Research Cores will ensure the rigorous design and conduct of these REACH Center-funded projects. The PROMISE (Pediatric Research Optimizing Methods in Stakeholder Engagement) Core assures the infrastructure necessary to engage important community and stakeholder partners in research. The IMPACT (Intervention Methods: Provision and Connection through Technology) Core assures the necessary technological and scientific resources to develop, test and evaluate outcomes of technology-enabled interventions. In partnership with other IDeA state programs, REACH Center resources will extend existing assets and expand the Delaware research community with important and unique emphases in child and family health and pediatric health equity.

PROJECT NARRATIVE It is essential to address the complex social ecological factors that persistently hamper the delivery of necessary healthcare, particularly in light of pervasive documented health inequities. The REACH (Research Expanding Access to Child Health) Center will strengthen pediatric health care research infrastructure by establishing a thematic, multidisciplinary health research system, rooted in the principles and methods of pediatric healthcare delivery science, and bridging our biomedical research and health care systems to assure equitable access to high quality pediatric health care for all. The REACH Center will propel scientific knowledge, technical capabilities, and clinical practice forward to improve health and health equity for children and families across Delaware with broad implications nationally.