ECHO Yakima Valley - ABSTRACT (new) ECHO Yakima Valley enriches the ECHO Program in two primary ways. 1) We will increase representation of rural and agricultural communities in the national ECHO Cohort so it may better support child health research across the range of American communities. Rural Americans are historically underrepresented in research, including in the Cycle 1 ECHO Cohort. With deep research ties to Washington’s Yakima Valley, our team is poised to enroll over 1000 pregnant women into the ECHO Cohort through partnerships with their prenatal and pediatric healthcare home. Biospecimen collection will be led by a sub-team with experience establishing and directing a biorepository for over 10,000 pregnancies. 2) Our investigator team spans various career stages and specialties and will implement an interdisciplinary approach to ECHO papers, incorporating insights from environmental health science, biostatistics, epidemiology, and pediatric medicine. We will apply our expertise to advance ECHO science to describe the relationships between commonly encountered pollutants (including fine particulate matter, ozone, and nitrogen dioxide) and major chronic pediatric health concerns, such as preterm birth, low birthweight, respiratory infections, asthma development and exacerbation, obesity, blood pressure, and neurodevelopment. We propose to lead a new ECHO-wide interest group on Air Pollutants and Wildfire Smoke as well as an interest group to bring together expertise in Rural Health. We will aim to develop new ECHO manuscripts to understand child health risks related to mixtures of common air pollutants, pesticides, and drinking water contaminants. We have plans for a set of novel preconception analyses addressing contaminants of concern for drinking water wells, an underdeveloped topic for ECHO. We also propose to expand ECHO Program data resources with advanced models for estimating participant exposures to ultrafine particulate matter and wildfire smoke. We plan to lead development of brief, low-burden extensions to the ECHO Protocol to better characterize family knowledge of the Air Quality Index (AQI). These data will allow ECHO scientists to explore opportunities to improve access to this public health tool as well as evaluate its effectiveness in mitigating health effects. A proposed novel Wildfire Rapid Response Protocol will enable natural experiment analyses of wildfire related health crises nationwide. Overall, ECHO Yakima Valley will build on our team’s prior successes and insights we gained as the ECHO PATHWAYS multi-cohort award center point for project coordination and team science. We will continue these efforts in ECHO Cycle 2 with a focus on solution-oriented research that may efficiently and directly inform public health policy and programs.