ABSTRACT Dartmouth is home to a robust pediatric academic program centered in the Children?s Hospital at Dartmouth (CHaD). During the first three years of ECHO funding, we have built a highly functioning pediatric Clinical Trials Unit and integrated it with clinical trials resources within the Dartmouth community and the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN). This has allowed us to support and expand the pediatric clinical trials portfolio, to recruit investigators and groups to this core, to leverage existing resources and develop new ones, to engage local as well as multi-center clinical trials, and to foster broad professional development. Our investigative team has contributed substantially to the development, leadership, and protocol design and implementation of the ISPCTN. The organization of our regional presence in the form of the Dartmouth Regional Pediatric Clinical Trials Unit (DRP-CTU) will allow recruitment of a diverse pediatric population, including those who are rural and underserved. Going forward, we propose to build on our existing infrastructure in support of clinical trial implementation and professional development. To accomplish this, we propose three Specific AIMS: 1. To develop institutional clinical research capacity targeting pregnant women and children with a special emphasis on rural and underserved populations. 2. To foster the professional development of faculty and support team members in the conduct of translational clinical research. 3. To stimulate and support our pediatric research community in the multicenter study of pediatric conditions and disease processes. We also propose a topical, impactful clinical trial to evaluate Youth Vaping Cessation Strategies, directed by thought leaders in this field. This initiative will provide a much-needed central coordinating platform for the conduct of pediatric clinical trials in the Dartmouth community. It will contribute to all aspects of the ISPCTN and will support existing and new investigators - expanding our clinical trials universe, stimulating expansion of our portfolio, and offering new opportunities for professional development with the resultant recruitment/training of new faculty and research staff.