PROJECT SUMMARY/ABSTRACT To take the first step in identifying and remedying real-world disparities and inequity among SGM populations, Moffitt Cancer Center began collecting sexual orientation (SO) in 2016 and gender identity (GI) in 2017 as standard-of-care demographic items in our electronic patient questionnaire (EPQ). Moffitt is one of the first NCI- Designated Cancer Centers to collect SOGI as standard-of-care demographics for all patients. All new patients are required to complete the web-based EPQ prior to, or on the day of, their first visit. EPQ data is integrated into the electronic medical record, and available at the point of care. To date, SOGI demographics have been collected on over 110,000 patients and ~3.5% of our patient population are self-identified as an SGM. Leveraging this valuable and largely unique data resource among NCI-Designated Cancer Centers, we propose the following Specific Aims to assess completeness of SOGI, identify potential disparities and inequity, address intersectionality, and identify the benefits and barriers of SOGI data collection. In Aim 1 we will assess completeness of SOGI data, identify disparities and inequity among SGM patients with cancer, and develop a real-time SGM dashboard. Patient-level data will be curated from the Moffitt EPQ, local cancer registry, electronic medical records, institutional databases, and billing and procedure records. Descriptive and quantitative analyses will be conducted to determine completion rates, modifiers of completion rates, and to identify potential disparities and inequity among SGM versus non-SGM patients with cancer. The curated data will be utilized to generate a real-time SGM dashboard to prospectively monitor SOGI completion rates, allow Moffitt investigators to identify SGM patients for research (i.e., cohort builder), and monitor disparities and inequity in real-time. In Aim 2 will we assess implementation outcomes, barriers, and facilitators of SOGI data collection and SGM healthcare delivery. Guided by the Implementation Outcomes Framework and the Health Equity Implementation Framework, we will use a mixed method approach (secondary data analysis, surveys, interviews) to evaluate implementation outcomes (reach, acceptability, feasibility, appropriateness) and multi- level barriers and facilitators that affect implementation among key stakeholders (healthcare providers, administrators, and patients). The long-term goals of this research are to 1) promote, facilitate, and improve our ability to conduct SGM cancer research and 2) expand and strengthen the evidence base for cancer care for SGM populations across the cancer continuum from prevention to survivorship. In this work, there will be concerted efforts to address issues of intersectionality.