Abstract West Virginia (WV) bears long-standing physical, psychosocial and fiscal characteristics, including the opioid crisis, limited resources and a restricted economy, that have significantly impacted the health of its residents. The West Virginia Pediatric Clinical Trials Network (WVPCTN), as a Clinical Site of the ECHO IDeA States PCTN (ISPCTN), has catalyzed emerging solutions to address some of these burdens by fulfilling its mission. Specifically, the mission of the WVPCTN has been two-fold - bringing clinical trials to our underserved population, and building professional capacity for clinical research. Our WVU site has been well positioned to be a successful Clinical Site due to a combination of structural and human resources that were already in place when the ISPCTN was initiated in 2016, and the background and expertise of the three PIs ? Drs. Saul, Pyles and Cottrell. The addition of the funds and resources provided by ISPCTN led to an acceleration of WVUs capacity to actively participate in clinical trials by allowing us to create a dedicated Pediatric Research Unit (PRU) and introduce a group of junior, less experienced clinical trial investigators, into both ISPCTN and non-ISPCTN trials. The effectiveness of this approach has been demonstrated through an increase in faculty participation in ISPCTN activities, a strong recruitment record, and an increase in the number of non-ISPCTN Pediatric trials at WVU. The WVPCTN is now actively growing an experienced investigator pool and a group of mentee investigators, all enhanced by the resources and expertise of the West Virginia Clinical Translational Science Institute (WVCTSI). These features and resources, together with strong and sustained partnerships throughout the state, and the multiple environmentally related conditions of our citizens, continue to uniquely position us to be successful as an ISPCTN Clinical Site and work to propose new trials for the network. This proposal for WVPCTN-2 will further add to a long-standing commitment to Pediatric-focused initiatives across the state. When funded, it will continue to position us to fully leverage additional funds that support Pediatric research infrastructure and provide access to cutting edge trials, both of which will positively impact the health of the children of WV.