Modified Project Summary/Abstract Section The Yakama Nation’s (YN) 31,000 residents reside on 1.4 million acres primarily within Washington state, and since 2021 there has been a 34% increase in drug overdose with most overdose deaths involving opioids, specifically fentanyl. This tragedy affects hundreds of Yakamas, and the YN’s Department of Health is working to address this urgent need. Taking a solution-oriented and innovated approach, the National Institute Health and YN partnership will develop research capacity and share data in real time to mobilize community members to promote culturally based, mental wellness and prevent these untimely deaths. The Yakama Nation NIH NCREW initiative is in partnership with the University of Washington and University of Michigan. The Broad Overarching Goals are: 1) End Suicide and Drug Overdose on and around the YN through integrating our knowledge and culture in the adaptation of Promoting Community Conversations About Research to End Suicide and Drug Overdose (PC CARES – DO). 2) Establish a research infrastructure to apply for and lead NIH funded research grants directly through the YN. 3a) Enhance our data management infrastructure to a) improve collection and access to quality data on suicide risk, attempts, and deaths and drug overdose indicators assessed at the individual, clinic, and community level; 3b) Develop procedures to produce timely feedback of data for decision-making. Our specific aims are: 1. Ensure community oversight as we design PC CARES-DO and develop research capacity for future efforts. We will establish 1) The Research Board who will produce policy and agreements that facilitate YN led research. 2) the Intervention Board to oversee the PC CARES-DO development and recommendations for future work. 2. Develop the PC CARES–DO curriculum with information and local data on opioid overdose prevention and harm reduction and integrate related wellbeing factors to maximize relevance, elevating Yakama cultural strengths. Modify PC CARES measures to reflect YN health promotion and preventative concepts and behaviors. 3. Develop a PC CARES-DO Implementation Strategy for successful and sustained implementation by identifying key contextual barriers, enablers, and costs. 4. Enhance our data management infrastructure to house YN program and research data and assess current suicide and drug overdose prevention, referral, treatment, and post care efforts to provide comprehensive, real-time data, responsive community-based training, and programming to prevent overdose and suicide in Yakama Nation.