PROJECT SUMMARY The incidence of non-alcoholic fatty liver disease (NAFLD), a known risk factor for hepatocellular carcinoma (HCC), is on the rise and disproportionately affecting the health of the Mexican-origin (MO) Hispanic population. Lifestyle behaviors which promote healthy eating patterns are the cornerstone prevention and treatment for NAFLD. Yet, epidemiological evidence evaluating dietary patterns, including those consistent with a traditional Mexican diet, are lacking. Recent analysis of these relationships in postmenopausal Hispanic women support a potential beneficial role in cancer mortality risk, which warrants further investigation in additional datasets and advancements using formative research to develop feasible, acceptable and impactful dietary interventions for NAFLD treatment among MO adults. Further, intervention studies in MO adults has identified barriers for participant engagement, including transportation, work schedules, and childcare. To build the epidemiological and intervention evidence related to diet and NAFLD risk in MO Hispanics, and answer the research question of whether effective dietary interventions can be developed and implemented to reduce the burden of this disease in the MO Hispanic population, two specific aims will be completed leveraging 1) pre-existing, de-identified data, from the Liver Ultrasound Nutrigenetic Assessment (LUNA) study in MO adults; and 2) LUNA study resources and infrastructure, including a subsample of participants to conduct qualitative work focused on knowledge, attitudes and beliefs of a traditional Mexican diet pattern and intervention delivery modalities, such as mobile health (mHealth) technology. Importantly, there is an opportunity to engage in formative research work under Dr. Garcia's (Co-sponsor) NIMHD-funded K01 and semi-structured interviews with Hispanic cancer survivors as part of Dr. Thomson's (Sponsor) role in the CDC-funded, national Cancer Prevention and Control Research Network. The proposed research aims are: 1) to examine the relationship between the traditional Mexican diet score and liver steatosis and fibrosis (NAFLD) and evaluate effect modification by sex and body mass index among 285 MO adults from the LUNA study, and 2) utilize formative research methods among MO adults participating in the LUNA study to design and develop an mHealth pilot feasibility traditional Mexican diet intervention. These research aims will address gaps in Ms. Lopez-Pentecost's training by 1) developing a highly informed and robust knowledge and skills in the field of nutritional cancer epidemiology with a focus on diverse populations, 2) gaining knowledge in formative, qualitative research that informs on the development of quality behavioral intervention trial designs, including mHealth applications, and 3) increasing scientific publication and presentations, as well as grant writing skills contributing to career development. With this award, the sponsoring team, and available ...