Boston Health Equity & community-Aligned Learning Health System (Boston-HEALHS) - PROJECT SUMMARY - OVERALL The Boston Health Equity & community-Aligned Learning Health System (Boston HEALHS) e-STAR proposal will expand existing Learning Health System (LHS) capacity in a combined academic-safety net system to create a robust and innovative program of research and training in LHS science. The integrated efforts of three distinct cores will be managed by an experienced team of researchers and health system leaders, working closely with and informed by a network of patients, community groups, clinicians, educators, and other local stakeholders to ensure that the LHS research and training are community-engaged, patient-centered, and of the highest quality, and that findings from LHS research are rapidly employed to improve care delivery. The Administrative (Admin) Core will coordinate the overall activities of Boston HEALHS, creating an organizational structure that provide efficient, responsive, and inclusive governance, with a particular focus on engaging community, patient, and health system stakeholders in collaborative decision-making. The Admin Core will oversee the recruitment and retention of LHS scientists participating in the training program, centering diversity and equity at all stages, from job descriptions and initial outreach, through candidate selection, to long-term professional development and retention. The Admin core will conduct a data-informed, community- engaged process to identify priority topics for embedded LHS research, selecting those for which rapid-cycle research results will have a meaningful impact on clinical operations and patient outcomes. The Research Education Core (REC) will implement the LHS scientist recruitment, training, and retention. REC leadership will fully develop the recruitment plans, drawing on multiple existing programs in our academic- safety net partnership that promote equity. The LHS scientists matriculating in the program will be linked with mentorship teams including both experienced researchers and health system leaders and will work with them on detailed individual development plans that will be continuously updated during and beyond the training period. The REC includes a large group of experts in the AHRQ-defined LHS competency domains who will provide the LHS scientists with the tools to master these competencies, and the curriculum team will work with scientists to identify didactic training opportunities in the PCORI methodology standards. The Research and Data Analysis Core (RDAC) will connect LHS scientists participating in the training program, as well as embedded LHS researchers across the institution, with linked data resources ideally suited for rapid-cycle, clinically impactful research. The RDAC will employ community-engaged participatory research principles to inform the selection of priority research topics, while simultaneously developing innovative methods for the rigorous conduct of comparative effectiveness and patient-centered outcomes research in a safety-net setting.