Project SummaryLatino adults have higher age-adjusted rates of many chronic disease relative to overall US trends while alsohaving health advantages. Exposure to stress contributes to some of these disparities with implications fordiabetes cardiovascular disease cancer and mental illness. This project will clarify reported stressorsexperienced by Mexican-origin adults in a low-income medically under-served border community. Thiscommunity participatory research will: 1) elucidate our knowledge of stress and culturally-bounded protectivefactors through intensive ethnographically-grounded interviews (N = 50); and 2) examine relationshipsbetween reported stressors to objective measures of physiological stress systemic inflammation and chronicdisease risk. The latter will be achieved through a representative household survey of Mexican-descent adults(N = 320). Each of two yearly follow ups will assess biomarkers and self-reports on several factors: validpsychosocial scales (e.g. socially embedded stressors); protective social and culturally-tied factors; andculturally-relevant coping resources (e.g. perceived individual support available and persons' openness toreceive support). Objective health metrics include markers of inflammation and systemic dysregulation (i.e.hsCRP Il-6; cortisol) and Life's Simple 7 (i.e. A1c; cholesterol; blood pressure; adiposity; smoking; physicalactivity; diet). Longitudinal models will be used to predict biomarker and chronic disease risk and test fordifferential sub-group patterns. Innovative minimally invasive and community responsive methods will beused for biomarker data collection--specifically from dried blood spot immediately available assessments ofA1c BMI and BP and cortisol from hair. Cortisol in hair and nails reflect more chronic stress indicators thanmore commonly studied measures and have particular promise as endpoints in stress managementinterventions. Cortisol in keratin samples better parallels expected lengths of behavioral intervention trialscompared with highly transient levels observed in saliva serum and urine. Analysis of the cohort data will alsodirectly inform sub-population targeting for a series of focus groups (N = 90). A minimum of 4 groups for eachbiologically identified sub-populations will be conducted: those for persons of uniform high stress (highreported stress and high biologic stress) those of uniform low stress and those that appear resilient (high inreported stress but lower than expected biologic stress). The adaptability of a promising stress-managementCHW intervention recently tested with Latinos in Connecticut will be explored. Key informant interviews withcommunity stakeholders and a community advisory board leveraged from a five-year prevention researchcenter beginning October of 2019 will further prepare us to submit a clinical trial to reduce and mitigatestressors. Thus the data generated from this study will be invaluable to conducting a prevention trial to reducestress and chronic disease in our community and in determining methods and models for other populations.