PROJECT SUMMARY/ABSTRACT Food allergy (FA) is a potentially life-threatening condition that affects 8% of children in the United States. Although racial and ethnic differences in the prevalence and severity of other atopic conditions such as asthma and eczema have been well described, little is known about differences in FA. Black and Hispanic children may have worse clinical outcomes than their White counterparts. Less is known about FA among Asian populations in the US. Phenotypic and endotypic differences, including rates of sensitization and co- morbidities are currently examined. Data on racial differences in FA management practices, especially as children enter adolescence are incomplete. Families with food-allergic children may experience impairments in psychosocial outcomes, however, these data come primarily from White, privately insured families. The goal of the parent R01 FORWARD award is to: 1) Determine factors associated with differences in the development of tolerance and new FAs, 2) Determine differences in FA management and outcomes during adolescence, and 3) Identify phenotypic and endotypic differences in FA. Currently, the FORWARD cohort contains 1,357 Asian, Black, White, and Hispanic/Latino children with physician diagnosed FA. Recruitment will continue at all four study sites until the study reaches a goal of 1,650 children. Study data includes: quarterly online surveys, annual biospecimen samples, and FA-related electronic health record (EHR) data. To achieve the parent award goals, EHR data integration from all FORWARD sites is needed. However, EHR data extraction from individual sites have been inconsistent and variable. Harmonizing data has been challenging due to the variations in underlying FA clinical documentation, data structures, and data presentations at different sites. To overcome this barrier, the study team plans to use the Observational Medical Outcomes Partnership (OMOP) common data model (CDM), a person-centric model that enables transformation of data from diverse observational databases into a common format with standardized vocabulary to be used to perform systematic analyses. Therefore, this proposed administrative supplement aims to: 1. Transform FORWARD participants’ FA clinical data from site-specific EHR systems into the OMOP CDM. 2. Evaluate the conversion of site-specific EHR data to the OMOP CDM. 3. Generate monthly electronic extraction of OMOP CDM compatible EHR data for FORWARD participants. 4. Initiate the implementation of standardized allergist note templates into each site’s EHR system.