PROJECT SUMMARY/ABSTRACT This proposal describes a five-year research and career development plan that will allow Dr. Hofstetter to achieve her goal of becoming an independent clinical investigator conducting patient-centered comparative effectiveness research relevant to pediatric vaccination. Her proposed project aims to increase influenza vaccine uptake in hospitalized children by identifying and meeting the influenza vaccine decision-making needs and preferences of parents and reducing influenza vaccine delivery barriers through the use of health information technology. The proposal builds upon her training in pediatric medicine, epidemiology, and basic research and biostatistical methods as well as her prior experience examining timely vaccination coverage, vaccine effectiveness and safety, and the impact of vaccine reminder/recall systems. This proposal provides a detailed plan of how Dr. Hofstetter will enhance her knowledge and skillset through advanced coursework and other learning opportunities in qualitative and participatory design methodology, comparative effectiveness research, health informatics, and dissemination and implementation science. Dr. Hofstetter will conduct the proposed research and career development activities in a uniquely rich and supportive environment. She will receive exceptional mentorship from faculty with expertise in respiratory viral infections and immunizations, qualitative, participatory design, and comparative effectiveness research, and technology-based interventions. In the first aim of this proposal, Dr. Hofstetter will survey parents and conduct in-depth interviews of parents, nurses, and physicians to identify and understand the factors associated with influenza vaccination of hospitalized children. She will focus on parent vaccine decision-making, provider vaccine communication, and barriers to influenza vaccine delivery. In the second aim, she will conduct rapid process design workshops that utilize the information gathered and actively engage key stakeholders to develop a tailored influenza vaccination screening and communication tool. She will then work with an expert panel and beta-testers to further refine and integrate this tool in the hospital?s electronic health record. In the third aim, she will conduct a randomized cluster-crossover trial to assess the effect of this tool compared to the standard influenza vaccination screening tool on influenza vaccine uptake among vaccine-eligible hospitalized children and on parent visit experience in the vaccination context. These studies will provide critical information about parent vaccine decision-making stages and influencing factors, effective provider vaccine communication practices, and the use of a tailored technology-based tool to improve vaccine-related outcomes. Ultimately, this proposal will allow Dr. Hofstetter to develop an independent, high-quality research program dedicated to improving timely uptake of recommended vaccines in diverse populations and settings using novel patient- and family-centered approaches.