Project Summary/Abstract The overall goal of this application is to organize a local consortia of ambulatory primary care settings in Hawaii to form the Hawaii Clinical Research Network for Health Equity (HICRN-HE). The clinical research network will focus on the health disparity needs of the Indigenous Pacific People (IPP)–defined as Native Hawaiians, other Pacific Islanders, and Filipinos. The 2 largest health systems in Hawaii providing primary care to a substantial number of IPP [the Queen’s Health System (QHS) and Hawaii Pacific Health (HPH)] and Federally Qualified Health Centers on Oahu will be invited to join the HICRN-HE. The UG3 (first 2 years of the grant) phase will be devoted to developing the infrastructure for HICRN-HE. A secure analyzable and regularly updated patient data repository derived from electronic health records from QHS and HPH will be established to support database analyses of health disparity issues. A Clinical and Translational Research Registry will be created and maintained to link interested local researchers and their research capabilities with those seeking researchers for clinical research/trials. The HICRN-HE will develop a framework for monitoring the implementation phase of HICRN-HE clinical studies to ensure patient safety, adherence to study protocol, and ability to meet recruitment goals. The UH3 phase (years 3-5 of the grant) will be devoted to implementing 2 projects under the thematic health disparity problem of Non-Alcoholic Fatty Liver Disease (NAFLD). Project 1 will focus on NAFLD over the Lifespan in Hawaii and assess the prevalence, risk, co-morbidities, and age at onset of NAFLD in IPP. Project 2 will focus on rates and risks of NAFLD among our sexual and gender minority groups living with HIV to uncover the HIV-specific factors that may contribute to risk above and beyond those in the general population.