EVALUATING BIOLOGIC AND SOCIAL DETERMINANTS OF HEALTH TO IMPROVE DIABETES PREVENTION AND ADDRESS HEALTH INEQUITIES IN LATINO PATIENTS. - PROJECT SUMMARY/ABSTRACT LUIS A. RODRIGUEZ, PHD, MPH, RD IS A DIABETES EPIDEMIOLOGIST AND RESEARCH SCIENTIST I (EQUIVALENT TO ASSISTANT PROFESSOR) AT THE KAISER PERMANENTE NORTHERN CALIFORNIA DIVISION OF RESEARCH. HIS LONG-TERM GOAL IS TO BECOME AN INDEPENDENT RESEARCHER WITH A FOCUS ON ADDRESSING DISPARITIES IN TYPE 2 DIABETES, PARTICULARLY AMONG THE US LATINO POPULATION (DEFINED AS PERSONS WHOSE ORIGINS ARE IN LATIN AMERICA). APPROXIMATELY 22% OF LATINO ADULTS ARE AFFECTED BY TYPE 2 DIABETES COMPARED TO 12% OF WHITE ADULTS. AN ADDITIONAL 38% OF LATINO ADULTS HAVE PREDIABETES, A STATE OF INCREASED DIABETES RISK, AND MAY FACE MORE BARRIERS TO PARTICIPATION IN EFFECTIVE TYPE 2 DIABETES PREVENTION INTERVENTIONS. ENGAGEMENT IN EVIDENCED-BASED DIABETES PREVENTION PROGRAMS HAS HISTORICALLY BEEN LOW, PARTICULARLY IN LATINO POPULATIONS. DEVELOPING PREDICTION TOOLS SPECIFIC TO THIS POPULATION USING READILY AVAILABLE DATA FROM THE ELECTRONIC HEALTH RECORD (EHR) TO IDENTIFY THE HIGHEST-RISK PATIENTS, ALONG WITH STAKEHOLDER ENGAGEMENT TO IDENTIFY HOW THESE TOOLS CAN BE USED TO IMPROVE PARTICIPATION IN DIABETES PREVENTION PROGRAMS, IS A PROMISING APPROACH TOWARDS IMPROVING DIABETES HEALTH EQUITY. THE PROPOSED RESEARCH AIMS TO BUILD A LARGE COHORT OF LATINO PATIENTS AT RISK FOR TYPE 2 DIABETES AND: 1) DEVELOP AND VALIDATE TYPE 2 DIABETES RISK PREDICTION MODELS USING EHR DATA THAT UNIQUELY INCORPORATE NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD), SOCIAL DETERMINANTS OF HEALTH FACTORS, AND THEIR INTERACTION; 2) EVALUATE SOCIAL DETERMINANTS OF HEALTH AND OTHER CLINICAL FACTORS IMPORTANT FOR TYPE 2 DIABETES PREVENTION PROGRAM ENROLLMENT AND ENGAGEMENT; AND 3) IDENTIFY HOW THESE MODELS CAN BE USED BY PATIENTS, CLINICIANS AND HEALTHCARE SYSTEMS TO REDUCE INCIDENT DIABETES. A MAJOR STRENGTH OF THE PROPOSED RESEARCH IS THAT MODEL DEVELOPMENT AND APPLICATION WILL BE CONDUCTED IN AN INTEGRATED HEALTHCARE SYSTEM SERVING OVER 4.5 MILLION MEMBERS WITH A STRONG RECORD OF SUCCESSFULLY IMPLEMENTING EHR-BASED CLINICAL SUPPORT TOOLS. THIS WILL BE FOLLOWED BY VALIDATION IN AN EXTERNAL COHORT OF LATINO ADULTS TO ASSESS GENERALIZABILITY. TO SUPPORT THE PROPOSED RESEARCH AND DR. RODRIGUEZ'S GOAL OF FUTURE INDEPENDENT RESEARCH IN TYPE 2 DIABETES DISPARITIES, THIS K01 PROPOSAL INCLUDES A FORMAL, MENTORED TRAINING PROGRAM TO: 1) ACQUIRE SPECIALIZED TRAINING IN ADVANCED PREDICTIVE MODELING (MACHINE LEARNING) USING EHR DATA; 2) DEVELOP CONTENT EXPERTISE IN THE SOCIAL DETERMINANTS OF PREDIABETES AND NAFLD; AND 3) TRAIN IN IMPLEMENTATION SCIENCE TO GAIN EXPERTISE IN TRANSLATION AND ADOPTION OF RESEARCH INTO CLINICAL PRACTICE. THE EVIDENCE GENERATED FROM THIS WORK WILL FORM THE FOUNDATION FOR AN R01 APPLICATION TO TEST STRATEGIES THAT WILL INCREASE ENGAGEMENT IN TYPE 2 DIABETES PREVENTION PROGRAMS AND REDUCE DIABETES INCIDENCE IN THE LATINO POPULATION. IN SUMMARY, THE PROPOSED K01 AWARD WILL ADVANCE DIABETES PREVENTION HEALTH EQUITY FOR LATINO PATIENTS AND PROVIDE VITAL SUPPORT FOR THE CAREER DEVELOPMENT OF DR. RODRIGUEZ BY HELPING HIM ACQUIRE THE SKILL SET AND EXPERTISE REQUIRED TO BECOME A SUCCESSFUL, INDEPENDENT INVESTIGATOR.