PROJECT SUMMARY/ABSTRACT Structural determinants of health are societal structures and macro-level policies that lead to key exposures, such as racial discrimination and disparate access to social and health services. While inequities in social determinants of health (SDOH) undoubtedly shape health outcomes, solutions to these inequities have primarily focused on individual and interpersonal factors, with limited effect. Effective structural and policy solutions are needed to reduce and eliminate disparities, and these must address the historical, cultural, political and institutional influences that restrict access to resources and quality health for minoritized communities. Although community-led health structural interventions are essential to address complex structural drivers of health disparities, research that can alter the social context and trajectory of health inequities in this area is often negatively impacted by limited resources and fraught, superficial relationships with academic partners. To tackle these problems, we will establish the SHHARE Community Project: The Shared Hub for Health Action Research and Equity to provide support and resources to community organizations and coalitions to strengthen their capacity, leadership and success in tackling structural drivers to health inequities. SHHARE is strongly positioned to serve as a ComPASS Health Equity Research Hub given our extensive expertise and track record in using a community-based participatory research (CBPR) approach with minoritized and underserved populations to address structural determinants, with specific expertise in social/cultural factors and nutrition/the food environment. SHHARE maximizes strong and long-lasting partnerships between NYU Langone Health (NYULH) and local and national community-based organizations, multi-sector partners, and renowned multidisciplinary experts at NYULH and Cicatelli Associates Inc (CAI). Guided by CBPR principles, SHHARE will support and ensure independence of community-lead health equity interventions (CHESIs) by: 1) Establishing a centralized, interdisciplinary administrative and coordinating team (ACT) unit to support research planning, implementation, monitoring, evaluation; disseminate findings, and promote sustainability of CHESIs and their interactions with ComPASS; 2) Providing methodological technical assistance and expertise through the research methods and data management (RMDM) unit to support CHESI teams to finalize interventions and research designs; 3) Strengthening CHESI leadership and competencies in structural determinants of health and health equity research through a community engaged research capacity building and training (RCBT) unit that provides technical assistance; and 4) Developing a sustainable community engagement and health equity (CEEQ) unit that supports all CBPR activities within SHHARE and among the assigned CHESI projects. Our proposed Health Equity Research Hub will empower and support CHESI teams to successfully implement broader structural change that targets inequities in SDOH to cultivate communities of practice that shift paradigms about community-led solutions to ensure measurable gains in health equity.

PROJECT NARRATIVE Effective structural and policy solutions are needed to reduce and eliminate disparities, and these must address the historical, cultural, political and institutional influences that restrict access to resources and quality health for minoritized communities. Community-led health structural interventions (CHESIs) are essential in addressing complex structural drivers of health disparities, however research in this area is often negatively impacted by limited resources, and fraught, superficial relationships with academic partners. To tackle these problems, the SHHare Community Project: The Shared Hub for Health Action Research and Equity in Community-led Interventions at NYU Langone Health (NYULH) will use a community-based participatory research approach to support and ensure the independence of assigned CHESIs by establishing robust, complementary units that ensure CHESIs can successfully implement broader structural change that shift paradigms about community-led solutions to ensure measurable gains in health equity.