Abstract Background: Rural, low-income communities in the U.S. experience a disproportionate burden of cancer, with higher incidence and mortality rates linked to structural and environmental disparities. Advanced glycation end products (AGEs), byproducts of metabolism that accumulate with poor diet and metabolic stress, have emerged as a novel biological link between social disadvantage and cancer risk. Yet, exploration of this biomarker in low-resource communities is challenging. The Partnership to Improve Community Health (PICH) cohort was launched to investigate how diet, neighborhood deprivation, and environmental exposures impact biological aging and gut microbiome changes linked to cancer risk in rural Southern Virginia (VA), a region that is ∼50% African American. This abstract highlight key lessons learned from the community-engaged development of this multi-level cohort. Methods: To ensure cultural relevance and feasibility, a Community Cohort Study Advisory Team (CCSAT) was established, with ∼15 representatives from local community organizations, Federally Qualified Health Centers (FQHCs), colleges/technical schools, Community Health Workers (CHWs), and community champions. From October 2024 to May 2025, six structured meetings were held to receive feedback on study elements. The PICH cohort will enroll ∼1,000 adults from rural Southern VA. Participants will complete structured interviews on their lifestyle, medical history, diet (including meat preparation), unmet needs, and stress. Biological specimens (blood, stool, saliva, urine, hair, buccal swabs, toenails), environmental samples, and Area Deprivation Index data will be collected. CCSAT input was integrated throughout the study protocol and implementation plan. Results: CCSAT input has been provided on the study protocol, recruitment materials (e.g., posters, flyers), survey content (e.g., adding a question on military service), biospecimen instructions, study title, and study consent form. They guided recruitment communication strategies and helped develop plain-language explanations for technical content. The CCSAT suggested flexible survey modes (phone/online) to accommodate participants’ preferences and digital literacy. They guided recruitment strategies through CHWs, FQHCs, and community events. Feedback helped tailor, remove, or add study components to improve clarity, cultural fit, and logistical feasibility. For example, one proposed study component—collecting wall scrapings for lead analysis—was removed following strong community objection. Conclusion: Engaging community stakeholders throughout study design helped tailor the PICH cohort to focus on the unique needs of a rural, underserved population. This process strengthened community trust, improved alignment with local infrastructure, and is expected to enhance participant recruitment and retention. The PICH study offers a model for culturally responsive, community-informed research to address cancer risk in underserved rural populations. Findings will inform precision prevention and locally relevant interventions. Citation Format: Hania M. Taha, Kara P. Wiseman, Samyukta Venkatesh, Anasia Harrell, Lindsay Hauser, Wendy Cohn, Matthew Devall, Li Li. Community engagement in designing a lifestyle, environmental, and biological risk factor cohort study for cancer disparities abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A065.
Taha et al. (Thu,) studied this question.