Project Summary A major impediment to research on sexual and gender minority (SGM) cancer prevention, treatment, and survivorship is the lack of information about sexual orientation and gender identity (SOGI) in medical records and cancer registries. Given what is known about risk factors for cancer incidence and mortality in SGM populations, including higher rates of tobacco use, alcohol use and obesity and lower rates of cancer screening in some groups, this lack of data is an impediment to achieving equitable health outcomes for SGM individuals. In addition, failure to assess SOGI in clinical settings prevents providers and staff from delivering culturally competent care. To address these problems, and in accordance with the goals of the NCI Administrative Supplements for the P30 Cancer Center Support Grants to Enhance Sexual Orientation and Gender Identity Data Collection, this project will focus on implementation of the National Academies of Science, Engineering and Medicine (NASEM)-recommended SOGI measures at the Fred Hutchinson Cancer Center (FHCC). The aims of the project are to: (1) identify patient, provider/staff, administrator and research-stakeholder barriers and facilitators of SOGI data collection in the cancer care setting; (2) tailor SOGI data collection implementation plans to address barriers and facilitators and facilitate staff training on interventions to improve the collection of this data; and, (3) following implementation of SOGI data collection across pilot sites, evaluate the feasibility, acceptability, appropriateness, and completeness of data in the electronic medical record. This project is significant in that it focuses on an NIH-defined disparities group that has been underserved in cancer research conducted to date, and it evaluates the implementation of SOGI data collection not only in the central hub of an urban Comprehensive Cancer Center but also at an affiliated safety-net hospital with an underserved cancer care population. It is also innovative in that it will provide a model for a novel implementation of SOGI data collection with the goal of creating a new standard of care throughout the Center’s catchment area, which is the entirety of Washington state.