SOCIAL DETERMINANTS OF HEALTH RESEARCH PROJECT – ABSTRACT Cancer is a leading cause of death in Chicago, and Black, Latinx and low-income Chinese communities in Chicago face significant cancer health inequities. Many observed racial/ethnic disparities in cancer outcomes are avoidable and research continues to identify structural racism and Social Determinants of Health (SDOH) as the major causes of cancer health inequities. Cancer patient navigation (PN) interventions have demonstrated efficacy in resolving patients’ SDOH barriers to care and improving completion and consistency of cancer care events, such as screening, follow-up, and treatment initiation among minoritized populations. The evidence has contributed to the designation of PN as an evidence-based intervention. However, traditional cancer PN involves navigators working with patients on a case-by-case basis, serving as a “Band-Aid” – temporarily mitigating some effects of multilevel barriers to care – but rarely producing provider- and structural-level change in cancer care delivery. Thus, we apply our experience from over a decade of PN research, in partnership with community- based organizations with deep roots in Chicago’s Black, Latinx, and low-income Chinese communities, to develop and test novel multilevel PN approaches within Learning Health Systems that propel a potentially transformative new cancer PN paradigm where navigators have the tools to contribute to sustained provider- and systems level care improvements that address SDOH and close cancer care delivery gaps at scale. Our PN innovations address key priorities identified by our ACCERT Center community partners and in accordance with the Center’s theme, will address structural racism, language accessibility, health literacy, and other SDOH with the goal of mitigating cancer health inequities in Chicago’s Black, Latinx, and low-income Chinese communities. In Aim 1, we will employ community-engaged participatory design methods to refine two multilevel PN approaches: (1) remote PN augmented by interactive artificial intelligence (AI) agents that will automate certain PN tasks and support patient education and coaching; and (2) remote PN augmented with 4R Oncology (4R=Right Information and Right Treatment to the Right Patient at the Right Time) – a model which uses systems engineering principles and Care Sequences with checklists to facilitate systematic patient-facing care planning and team-based care delivery involving patients, providers of cancer care, social care and supportive care. In Aim 2, we will conduct a Hybrid Type 2 randomized effectiveness-implementation trial with N=735 Black, Latinx, and low-income Chinese adults in Chicago to compare the effectiveness of the novel PN approaches relative to Standard PN in resolving SDOH-related barriers and improving patient receipt of cancer-related health services (patient-level outcome), and improving patient-provider communications, and reducing medical mistrust and expe...