ABSTRACT- OVERALL This proposal is a competitive renewal of the Institutional Development Award Program Infrastructure for Clinical and Translational Research (IDeA-CTR)(U54) grant originally awarded in September 2013 to the University of Delaware. The ACCEL CTR Program, has completed nine years of funding at the time of this application. During our third funding cycle (ACCEL3), our consortium will consist of four partners: University of Delaware (UD)—the lead institution; Nemours Children’s Health (Nemours); Christiana Care Health System (CCHS), the largest health care system in Delaware; and Delaware State University (DSU), an American historically Black, public university that joined our consortium during the last competitive renewal. Over the past nine years, ACCEL has established an exceedingly strong network and infrastructure for clinical and translational (C&T) research within the state of Delaware; and, we are now poised and ready to continue our growth trajectory. While we will continue with the activities that have made us successful, we will have a sharper focus on building sustainable infrastructure across the state that can continue to thrive and mature for years to come. And, we will focus on creating a scientific culture focused, not only, on improving the health of Delawareans, but doing so through a lens of health equity. In our mission to establish a cadre of successful C&T scientists in DE, we will use various approaches to promote full consideration of how their work impacts the needs of all members of society, from design to study implementation to dissemination of findings. And, we will have a much greater focus on building a bi-directional relationship between our scientists and the community so that we can have a greater impact on Delawareans. Delaware is an ideal state for a CTR grant as it represents the whole of the USA in a compact form. The population of Delaware (~970,000) mirrors the US population in urban-to-rural citizen ratio and ethnic/racial diversity, with 23% African American, 62% Caucasian, 10% Hispanic, 4% Asian and 1% Native American. Thus, studies involving a cross-section of Delaware can be generalizable to populations nationally. The dominance of adult (CCHS) and pediatric (Nemours) hospital systems, which serve at least 85% of the residents of the state, provides a unique opportunity to treat the state of Delaware as a model for examining how healthcare changes can impact population health. The overarching goal of the ACCEL CTR Program is to create a unified Delaware Clinical and Translational Research Community (inclusive of investigators and community members) that breaks down existing barriers, capitalizes on the unique strengths of its partners to establish infrastructure and accelerates the creation of equitable solutions that improve the health of all Delawareans and all Americans.

PROJECT NARRATIVE- OVERALL While Delaware has high quality healthcare compared to other states, Delaware still has significant inequities in health and healthcare for non-White Delawareans; further, Delaware lags behind other states in a number of areas, including drug deaths, obesity, high preventable hospitalization rates, multiple chronic conditions and cancer. As such, the overarching goal for the continuation of the ACCEL CTR Program is to create a unified Delaware Clinical and Translational Research Community (inclusive of investigators and community members) that breaks down existing barriers, capitalizes on the unique strengths of its partners to establish infrastructure and accelerates the creation of equitable solutions that improve the health of all Delawareans and all Americans.