Project Summary We propose to contribute a Bay Area, population-based prospective cohort to a nationwide cohort study of Asian American (AsA) men and women to address major gaps in evidence on the correlates and determinants of disease risk and health. We will recruit, characterize, and follow Chinese, Filipino, and Vietnamese Americans, three understudied AsA ethnic groups whose populations are rapidly expanding in the United States. Specifically, we will recruit 2,100 Chinese, Filipino, and Vietnamese Americans (700 of each ethnic group) in the San Francisco Bay Area to characterize cardiometabolic profiles and psychosocial and other health factors through extensive surveys, clinical assessments and assays, imaging studies, multi-omics, and digital technology. Although disease patterns and risk factors appear to vary among different AsA groups, previous research suggests that AsAs are highly affected by cardiometabolic disorders such as diabetes, hypertension, dyslipidemia, cardiovascular disease, stroke, non-alcoholic fatty liver disease, and obesity, as well as underdiagnosed mental health conditions and psychosocial issues related to immigration trauma, discrimination, and marginalization. However, epidemiological data on individual AsA groups are sparse, and most clinical guidelines and treatments are based on data derived from Caucasians. Our UG3/UH3 study site will collaborate with the Coordinating Center (U24), other study sites, and NHLBI to develop a large cohort of 10,000 members to characterize risk factors and disease patterns in individual AsA ethnic groups. The specific aims of the proposed study are to 1) contribute to the development of a Common Protocol for the study in collaboration with NHLBI, U24, and other UG3/UH3 investigators and establish a state-of-the-art populomics cohort; 2) measure the prevalence or distribution of baseline self-reported health and risk factors and clinical markers in each ethnic group and compare across ethnic groups; and 3) determine relationships among baseline risk factors in each AsA ethnic group, including self-reported stress and sleep as well as heart rate variability-derived sleep quality and stress from wearable biosensing data, with subsequent (incident) health outcomes during follow-up. This proposed study is innovative in its in-depth exposome phenotyping through comprehensive surveys that will include assessments of well-being and anxiety in addition to traditional risk factors, baseline clinical assessments, advanced digital technology, and integrative omics to understand the intersections of epidemiology, biology, psychology, and technology in physical and mental health. We will leverage these innovations alongside Stanford’s world-class resources in population health sciences to uncover critical cardiometabolic and psychosocial factors underlying health and disease in AsAs. This study will advance health and disease prevention and treatment and will lead to improved health and well-...