If you are proposing to test the impact of a proposed system alignment strategy on relevant measures of health and health equity, then you must have results from a pilot test of this system alignment strategy.  Pilot test results must demonstrate that it is feasible to implement your proposed system alignment strategy, and that the strategy is acceptable to relevant organizations and people who will help to implement the strategy – including representatives from medical, social, and public health systems and representatives from communities affected by the form of systemic racism under study.  If your LOI addresses Special Topic #1 (Page 3 of the CFP document), your study might not focus on a specific systems alignment strategy that can be pilot tested.  Instead of pilot test results, you must have documentation of results from another type of preliminary research study that demonstrate the scientific premise and/or the feasibility of your proposed research strategy.  For example, your preliminary research results may provide preliminary support for the hypothesis that a specific form of systemic racism results in inequitable health outcomes for affected populations, such that your proposed new research will seek to build upon this preliminary evidence and offer a more definitive test of this hypothesis.  Additionally, your preliminary research results may demonstrate the feasibility of key elements of your proposed scientific approach, such as your ability to recruit research participants, your ability to obtain needed data and data use agreements, your ability to achieve sufficient sample sizes needed for statistical power, the validity and reliability of the measures you will use, and your ability to secure the engagement and cooperation of representatives from relevant medical, social, and public health systems.