Alliance for Clinical and Translational Research (Alliance) - Title: Alliance for Clinical and Translational Research (Alliance) OVERALL ABSTRACT Puerto Rico's (PR) geographic location, heterogeneous population, and robust research infrastructure present unique opportunities for researchers to conduct, implement, and evaluate transformative clinical and translational (C&T) research to improve the health of populations worldwide. This competitive renewal will continue and build upon the robust foundation for C&T research established by the Alliance for Clinical & Translational Research IDeA CTR-N (Alliance) in PR during the previous award period. In its initial four-year grant period, the Alliance created the first Practice-Based Research Network (PBRN) in PR, established partnerships with community-based research organizations, and enhanced the representation of people from PR in national collaborative projects and datasets. Alliance-supported investigators authored or co-authored more than 200 publications cited 1,200 times globally and obtained $174 million of external funds, with a 59% success rate. During the next cycle, the overall goal of the Alliance will be to strengthen and expand all domains of C&T research in PR, including resources, scientific activities and outcomes, and health and societal benefits. The Overall Strategic Plan for the new cycle is structured around three main Priority areas/Overall Specific Aims: Aim 1 (Infrastructure and Resources): We will strengthen and expand the island-wide infrastructure and human resource network for conducting C&T research in PR and other IDeA states. Aim 2 (Research Development): We will drive and sustain trans/multi/interdisciplinary research that addresses the health needs of people living in PR and in the United States Mainland, and we will increase their participation in national collaborative projects and clinical trials. Aim 3 (Community Health-Centered Innovation): We will boost the health and societal benefits of C&T research by engaging new stakeholders, such as PBRNs, local industry, and policy experts, in a dynamic partnership with academic researchers and community members to develop novel approaches to health challenges of our population. To meet its goals, the Alliance will apply the Quadruple Helix (QH) Innovation System—an established R&D framework—to drive innovation and broaden its impact (Alliance Health Innovation Model). The Alliance is strategically positioned to improve health outcomes for people living in PR and in the US Mainland by broadening participation within clinical cohorts and research teams and by adopting community-centered strategies for patient recruitment in alignment with NIH priorities and guidelines.