ABSTRACT: Project 1: BRAICELET- Bio-Repository for American Indian Capacity, Education, Law, Economics and Technology. To help reduce the myriad of health disparities in American Indian populations, this proposal's primary aim focuses on the establishment of the first tribally-owned biobank as a conduit for education on the benefits of precision medicine and big-data health science. Here, BRAICELET- Bio-Repository for American Indian Capacity, Education, Law, Economics and Technology will be initiated with the eminent Lakota Sioux community. This will serve as a proof of principle study on how educative and capacity building methods can promote long term self-sustainability and autonomy on advanced health care practices and management. The Stanford Biobank HIMC (Human Immune Monitoring Center) will act as a blueprint, whereby best lab protocols and secure database management programs will be adapted to include Lakota language and cultural/ceremonial practices. This proposal has the advantage of an ongoing collaboration with the Lakota community for an ?omics study on rheumatoid arthritis (RA) called SAIL (Studies in Autoimmune Illnesses with the Lakota). As an extension of our SAIL partnership (AIM 2), an additional 200 samples will be accrued from the community and will act as the first bio-specimens that will be collected, tested (genotype and transcriptome partnered with Stanford) stored and managed at BRAICELET. A focus on progress and dissemination of this SAIL ?omics work will be embedded in the third aim of this proposal. This will be done first through creating a health science literacy and education curriculum adopted from Stanford's ?big data? course program and tailored to the Lakota grassroots community and health care workers. Courses will include big data ethics, disease risk assessment through ?omics analysis and the advantages of pharmacogenetics. To monitor if genetics and precision medicine course information is effectively communicated with the Lakota members, a five point knowledge assessment method/questionnaire will be used with BRAICELET recruiters and SAIL participants. An iterative evaluation of this questionnaire will assess progress and actively implement improvements to the curriculum. The growing attention to environmental, climate/geography and socio-economic relationships with genetic health data is now at the national and international level. BRAICELET takes this into account with context of geography, culture and environmental exposure of one group, in one place. This greatly increases the power, validity and usefulness of conclusions from precision medicine research studies. A bio-repository is an opportunity for tribal nations to retain & manage their own biological material on-site and further learn and define for themselves the benefits of big-data health science. Undoubtedly, an American Indian representation, scientific/cultural/political exchange and perspective will be of great value.