The Gordon and Betty Moore Foundation is funding health services research projects to expand the base of rigorous evidence about pre-hospital diagnostic delays – i.e., those that occur before a patient reaches the care setting where their condition is diagnosed. The goal of the study is to estimate the extent to which racial disparities exist in pediatric severe sepsis/septic shock outcomes and to understand how appraisal and help-seeking behaviors may differ by race. Sepsis is a leading cause of morbidity and mortality in childhood with a 10-20 percent mortality rate, more than 100,000 emergency department visits, and $7 billion in costs each year. Black children experience higher mortality and worse outcomes for sepsis compared with white children, although the mechanism of this disparity represents a critical gap in our understanding. The researchers will use New York statewide data to examine quantitative differences in severe sepsis/septic shock outcomes by race, insurance status, socioeconomic status, and other factors. Informed by community input and previous research on health seeking-behavior and medical mistrust, they will also conduct and analyze interviews with caregivers to better understand when and how caregivers decide to seek care for their child in the presence or absence of a fever. Deliverables will include a project work plan, narrative and financial reports, and a range of products to reach clinicians, policymakers, and other audiences for study findings.