Paul Coverdell National Acute Stroke Program - As the fifth leading cause of death in Virginia, the Virginia Department of Health (VDH), has worked to address stroke risk factors and increase awareness to the signs of a stroke over the past three years under CDC DP21-2102 (Stroke) funding. Through that funding, VDH developed relationships and engaged healthcare and community partners to reduce stroke burden, address disparities, and increase utilization of social and support services. Through DP24-0060, VDH will implement and evaluate three CDC evidence-based strategies focused on data monitoring, team-based care, and clinical-community linkages. VDH has developed four core activities to implement these strategies: the Virginia Stroke Continuum Program, the Virginia Stroke Registry, community health referrals, and Stroke Smart Virginia. VDH, Virginia Hospital and Healthcare Association, and Unite Us will facilitate two cohorts (2.5 years per cohort) of multi-disciplinary teams across the stroke continuum of care (hospital, EMS, stroke rehabilitation, and community partner(s)). Each cohort will implement all CDC strategies and activities. VDH will continue to develop and grow the Virginia Stroke Registry to collect stroke patient data from all hospitals and EMS across Virginia. VDH will partner with the Virginia Stroke Systems Task Force and Healthy Hearts Initiative Learning Collaboratives to support community health hubs in which Community Health Workers screen and refer individuals to community resources. VDH will continue to scale Stroke Smart Virginia, a low-cost public health initiative to raise awareness about the signs of a stroke and the need for early 911 activation. These efforts will be implemented in targeted census tracts identified based on having a crude stroke prevalence rate 1.5 times greater than the crude stroke prevalence rate for the corresponding county. Through the four core activities, anticipated outcomes include increased use of EHR and HIT to address stroke burden and risk focusing on those with undiagnosed or uncontrolled hypertension, increased referrals to social services, implementation of quality improvement projects based on EHR/HIT and program data, and an increase in number and quality of partnerships to address stroke burden and increase educational reach.