PROJECT SUMMARY/ABSTRACT Hidradenitis suppurativa is a chronic inflammatory disease marked by painful, recurrent skin abscesses, cysts, draining sinus tracts, and disfiguring scarring. Hidradenitis suppurativa disproportionately affects racial and ethnic minority groups. Despite an awareness of these disparities, the underlying causes have not been adequately studied. Dr. Chang is seeking an NIH K23 Mentored Patient-Oriented Research Career Development Award to acquire the necessary mentored training, practical experience, and knowledge to become an independently funded clinical investigator of health disparities in chronic inflammatory skin diseases with a focus on hidradenitis suppurativa. Towards this goal, the overall objective of this application is to identify individual-level, interpersonal-level, and community-level factors that influence hidradenitis suppurativa epidemiology and outcomes. Understanding these multilevel factors and their interactions is pivotal for advancing our understanding of hidradenitis suppurativa and designing effective interventions to improve hidradenitis suppurativa management. Dr. Chang proposes to: 1) Use a large racially and socioeconomically diverse dataset to identify differences in hidradenitis suppurativa prevalence based on individual-level and community-level factors and to evaluate the association between individual-level and community-level factors and receiving biologic therapy for hidradenitis suppurativa; 2) Assess individual-, interpersonal-, and community-level factors associated with time to diagnosis by conducting a survey study of racially and socioeconomically diverse adults living with hidradenitis suppurativa; 3) Identify patient-reported facilitators of obtaining care for hidradenitis suppurativa using a mixed methods approach with racially and socioeconomically diverse study participants. A mentoring team with multidisciplinary expertise will guide Dr. Chang's career development and research progress: immune-mediated diseases (Dr. Yazdany), hidradenitis suppurativa (Drs. Naik and Linos), epidemiologic methods for observational studies (Drs. Yazdany and Linos), health disparities research (Drs. Yazdany and Ackerman), qualitative/mixed methods research (Drs. Ackerman and Linos). Their mentorship combined with focused training and the proposed research plan will develop Dr. Chang's expertise in health disparities research in chronic inflammatory diseases.