The NIH HEAL Initiative's OTA-23-007 seeks to enhance wellness among Native Americans by advancing research on overdose, substance use, pain, and mental health. Our project focuses on developing a Clinical Research Unit to implement a systems thinking Native Behavioral Health Effective Coverage Care Model (NBHECCM) for the Absentee Shawnee Tribal community. This model will use systems analysis to disentangle the complexity underlying these areas of behavioral health to enable us to improve care coordination, identify critical intervention points, and enhance the overall effectiveness of community health initiatives. We will develop a culturally attuned Native American Community Behavioral Health Systems Framework which includes the relevant thematic domains, stakeholders, and areas of interest relevant to pain management and behavioral health within the Absentee Shawnee Tribe and other indigenous communities. These include the areas of governance, community safety, community services, socioeconomics, family unit, treatment, and health service delivery, among others. Each domain will have specific areas of stakeholder interest. Community representatives from these domains will define the roles and interrelationships within and between these domains. The resulting stakeholder mapping will be used to identify unique and intersecting community interests that are related to overdose, substance use, pain, and behavioral health. To specifically address pain management, we will map community effective coverage, illustrated by Sankey diagrams that represent all potential paths an individual might take through the care continuum (e.g., the onset of pain, care-seeking, diagnosis, the pursuit of care, and ongoing management). This data will be used to create a system for Phase Two to analyze care trajectories and conditional probabilities of actual data to evaluate the cascade of care. This analysis will demonstrate how pain affects the community and identify critical intervention points to improve pain management and overall community wellness. Our NBHECCM will serve as a robust tool in Phase 2 protocols for understanding and addressing these complex health issues, aiming to ultimately enhance the quality of care and wellness in the Absentee Shawnee Tribe community as well as other Native American groups. This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions for the overdose epidemic, including opioid and stimulant use disorders, and the crisis of chronic pain. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction and acute and chronic pain.