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This multiple case study examines the Building Infrastructure Leading to Diversity (BUILD) initiative to understand how STEMM intervention efforts at the student, faculty, and institutional levels affect cultural and structural shifts across the 10 BUILD sites. Drawing on Theory-Driven Evaluation and Sociocultural Theory, we demonstrate how multi-level interventions lead to institutional changes that work toward enhancing the diversity in the biomedical workforce. Findings contribute to organizational change literature and provide insight for higher education program leaders interested in understanding how interventions contribute to institutional change.