This Competitive renewal application for the Center for Native and Pacific Health Disparities Research (CNPHDR or Center; P20 MD 000173) seeks 5 years of additional funding to develop a new paradigm for advancing the science of health disparities research using community engagement and empowerment to eliminate health disparities and the promotion of health equity. Our scientific theme will remain cardiometabolic health disparities among our priority populations of Native (Alaska Native, Native Hawaiians, New Zealand Maori) and Pacific Peoples (Pacific Islanders, Micronesians, Filipinos). The major focus of research investigation will include clinical, health services, interventional and translational research designs. The Center consists of 4 Cores (Research, Training and Education, Community Engagement and Administrative) and 2 Research Subprojects. Sub-project #1: Aims to examine racial/ethnic differences in the prevalence and cost of preventable hospitalizations due to heart disease and diabetes and to use this health administrative data to pilot test a hospital-based intervention to prevent re-hospitalization. Sub-Project #2: Aims to characterize the prevalence of intracerebral hemorrhage (ICH) and associated risk factors in the largest stroke center in the State. Initial results will then be used to inform a randomized contro trial to test a patient navigator program to improve prognosis and health related quality of life and post-stroke depression. The success of the overall CNPHDR hinges on the success of the individual cores to meet the OVERALL AIMS as follows: Aim#1: Design and implement health and health care disparities research studies of high impact to our priority populations. Aim#2: Build and train a diverse scientific workforce to actively participate in the health disparities research enterprise. Aim#3: Advance community engagement research approaches to strengthen participation of diverse communities in the research process and to empower communities to take action towards meaningful improvement in their own health and wellness. Aim#4: Integrate and centralize Native and Pacific Peoples health disparities research for the purpose of developing a new interdisciplinary science aimed at the elimination of health disparities and the promotion of health equity. The Center's proposal has many strengths: 1) It's organizational infrastructure is innovative in its approach to embrace community empowerment and engagement as the means to engender community participation in the research process and to build trust. 2) It's unique contribution to understanding cardiometabolic health disparities in 3 Native populations in the Pacific region. 3) Its commitment to build and train a diverse scientific workforce. 4) Its focus to synergize resources to stimulate a new paradigm of interdisciplinary health disparities science. 5) To prepare and empower our diverse Native and Pacific People communities to take ownership of their own health and wellness.