Asian American Community Cohort and Engagement Study (ACCESS) - Between 2000 and 2020, Asian Americans were the fastest growing racial group in the US, increasing from 10.5 million to 24 million individuals. Studies have documented that Asian Americans (AAs) experience chronic disease rates that converge with or exceed those of the general US population; notably, AAs are at higher risk for several cardiometabolic disorders despite having lower rates of obesity. However, due to limited data and the common practice of reporting aggregated data across AA populations, the true extent and nature of the health risks that exist are not well understood. Thus, to address important gaps in the field, we propose to establish the Asian American Community Cohort and Engagement Study (ACCESS), which will enroll over 2,000 Asian American men and women ages 25-64 recruited from across the greater Philadelphia-New Jersey-New York City region. Our multidisciplinary team will leverage our 22-year established PA-NJ-NYC Regional Network of collaborative community-based organization partners, clinical providers, city health departments, and academic investigators to support the cohort’s infrastructure, the recruitment of research participants, and data collection activities. Our team has a strong and successful record of scientific productivity and expertise in: 1) the conduct of longitudinal cohort studies; 2) rigorous assessment of dietary intake and other health behaviors; 3) standardized measures of psychosocial functioning, lifestyle factors, and neighborhood environment; 4) collection of high-quality biospecimens for analysis of biologic markers; and 5) assessment of cardiometabolic outcomes (e.g., hypertension, type 2 diabetes, cardiovascular disease). The overall objectives of this application are to establish a rigorous infrastructure of ACCESS including formalizing clinical/community partnerships, developing cohort infrastructure, and establishing study protocols to support the standardized collection of comprehensive psychosocial, behavioral, and neighborhood-level data, along with biospecimens and other clinical exams. The proposed activities are closely aligned with NHLBI’s Strategic Vision and will address key research questions regarding how the prevalence of cardiometabolic disorders varies across populations and the identification of behavioral and biologic pathways that may account for individual or group differences in disease risk. This synergistic multidisciplinary plan to establish a prospective comprehensive cohort will yield a rich resource to support rigorous research on multi-level pathways contributing to cardiometabolic disease risk and health outcomes. Study findings will inform clinical practice by illuminating novel risk factors and will support the development of more data-driven screening, prevention, and intervention guidelines that benefit the broader population.