Project Summary/Abstract It is well understood that rural populations, especially rural children, suffer disproportionately from several chronic diseases and risk factors that adversely impact quality of life. For example, rurality is associated with higher infant mortality, increased rates of lower respiratory tract infection hospitalization among infants and young children and lower rates of early childhood vaccinations for preventable disease. Resources and studies targeting rural heath have primarily focused on addressing problems of access to healthcare services and healthcare professionals, but improving overall health and reducing risks among rural children also requires a more comprehensive understanding of how prevention strategies can be developed for, adapted to, and tested in rural communities. Our overall goal is to build a sustainable Center for Prevention Research (CPR). The CPR is designed to support researchers in advancing across the prevention research continuum from state-of- the-art epidemiological and modeling CPR projects to R01-funded intervention research that is informed and developed through CPR support. Several key barriers limit the potential for developing a rural-oriented center focused on prevention research for children’s health, including (1) limited access to electronic health records; (2) modeling resources and methods that are primarily oriented to urban settings; (3) evidenced based intervention strategies that have been primarily developed for, and tested within, urban communities but few solutions that have been designed with input from rural-based stakeholders; and (4) challenges to establishing a critical mass of scientifically competitive investigators. The CPR is specifically designed to address these barriers and will achieve its overall goal through three specific aims. First, CPR will support, develop and expand a critical mass of researchers in Montana addressing rural children’s health issues. The Administrative Core will actively recruit new prevention researchers to the CPR through a variety of mechanisms including new hires, pilot projects and collaborations with other Montana campuses. Second, CPR will establish research cores that provide Center investigators with state-of-the-art technical tools and expertise to conduct epidemiological and modeling and transition to development and testing of intervention strategies to protect children’s health. The Data and Modeling Core will provide CPR researchers with a centralized resource that houses state-of-the-art data acquisition and management of sensitive data; biostatistics and modeling expertise; and high performance computational resources. The Stakeholder Engagement and Intervention Support Core will provide CPR researchers with survey and qualitative methods support to inform rural and stakeholder informed interventions Third, and ultimately, CPR will create a sustainable Center-based culture that fosters multidisciplinary success around prevention research for rural children’s health through mentoring, collaborative exchange and support for scholarly productivity and achievement.

Project Narrative Montana is one of the most rural states in the country, and rural children suffer disproportionately from several adverse health outcomes. The Center for Prevention Research will be a sustainable Center that fosters multidisciplinary research success to inform, develop and test strategies for improving rural children's health.