Abstract Asian Americans (AAs) represent approximately 7% of the U.S. population but account for over half of all Hepatitis B virus (HBV) infections nationally. Among the estimated 2.4 million Americans living with HBV, 58% are AAs, who exhibit the highest HBV prevalence across U.S. population groups. Despite recommendations from the CDC and U.S. Preventive Services Task Force to screen individuals at elevated risk, an estimated 68–75% of AAs remain unscreened and undiagnosed. Underdiagnosis has been linked to limited engagement with healthcare services, unfamiliarity with the healthcare system, and difficulties navigating available health information. Most existing studies have not fully examined how multiple layers of influence affect HBV screening and liver disease treatment. Preliminary findings among Chinese, Korean, and Vietnamese populations suggest that screening and care gaps stem from a range of individual and clinical factors. These factors contribute to delays in diagnosis, reduced services to treatment, and worsening liver disease. This study aims to identify and analyze individual and clinical factors that influence HBV-related liver disease management and outcomes. Using an adapted Socio-Ecological Model, the project will build upon a 20-year Regional Cancer Network and established collaborations with healthcare providers and local organizations in the Philadelphia, New Jersey and New York City metropolitan areas. Employing a mixed-methods approach, the research team will: Aim1. Analyze the longitudinal relationship between individual-level factors and HBV screening and liver disease management among 2,000 Asian American participants; Aim2. Evaluate the influence of organizational-level factors within clinical settings on screening rates and care continuity; and Aim3. Examine how patient-level behaviors and clinical care practices influence HBV screening and treatment outcomes. An integrative analysis will determine how factors at individual and clinical levels jointly impact engagement with HBV care. This will be the first longitudinal study to examine HBV-related liver disease management in high-risk Asian American subgroups, including those with early-stage liver cancer. The study findings are expected to support the development of targeted strategies to improve the quality of HBV and liver disease care for all populations at risk, contributing to national efforts to reduce the burden of chronic liver diseases.