Project Title: PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends

项目名称：PROSPECT：波多黎各社会心理、环境和慢性疾病趋势观察研究

• 批准号: 10408131
• 负责人: JOSIEMER MATTEI
• 金额: $ 61.75万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408131
• 关键词: Address; Adult; Area; Behavior; Biological; Biological Markers; Blood Pressure; Body Weight; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Caribbean region; Censuses; Cholesterol; Chronic Disease; Chronic stress; Clinic; Communities; Conflict (Psychology); Data; Databases; Diabetes Mellitus; Diagnosis; Diet; Disasters; Distress; Dyslipidemias; Environment; Environmental Risk Factor; Exercise; Food; Food Access; Fostering; Future; Glucose; Goals; Guidelines; Hair; Health; High Prevalence; Hurricane; Hydrocortisone; Hypertension; Impairment; Inflammation; Infrastructure; Intervention; Interview; Island; Knowledge; Latino Population; Leadership; Life Style; Link; Lipids; Longitudinal Studies; Longitudinal cohort; Measures; Medical Records; Mental Depression; Methods; Multiple Partners; Non-Insulin-Dependent Diabetes Mellitus; Nutritional status; Obesity; Observational Study; Outcome; PF4 Gene; Participant; Pilot Projects; Policies; Population; Prevalence; Psychosocial Assessment and Care; Psychosocial Factor; Psychosocial Stress; Public Health; Puerto Rican; Puerto Rico; Reporting; Research; Resources; Risk; Risk Factors; Rural; Sampling; Seminal; Social support; Stress; Surveys; Telephone; Time; Translations; Trauma; Underserved Population; Unhealthy Diet; United States; Variant; Visit; Vitamin D; biobank; cardiometabolic risk; cardiometabolism; cardiovascular disorder risk; cohort; depressive symptoms; design; dietary; disease diagnosis; disparity reduction; epidemiology study; ethnic minority; follow-up; food insecurity; food quality; food security; good diet; high risk; improved; meetings; men; prevent; programs; prospective; psychosocial; public health priorities; recruit; rural area; statistics; stress symptom; trauma symptom; trend

PROJECT SUMMARY Despite efforts to prevent chronic diseases, they continue to increase, with underserved ethnic minorities bearing the greatest burden. The United States (US) territory of Puerto Rico (PR) has high prevalence of multiple cardiometabolic conditions that increase risk of cardiovascular disease (CVD). Evidence supports a direct link between psychosocial and food-related environmental risk factors, and cardiometabolic conditions, but these remain markedly understudied at the island-wide population level in PR, despite the clear and pressing need to alleviate the burden of chronic disease in the island. On September 2017, hurricane Maria devastated PR, imposing urgency for studying trends and associations of risk factors for cardiometabolic conditions under times of distress. Thus, the overall goal for this application is to identify trends and longitudinal associations in psychosocial, food-related, and cardiometabolic risk factors that can guide public health priorities and future research needs aimed at reducing CVD-related disparities in PR. To this end, we will establish `PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends', an island-wide, longitudinal population cohort of 2,000 adults (30-75y) in PR recruited with a multi-frame sampling of probabilistic plus community approaches, and assessed in a network of several partner clinics across the island. The study will collect comprehensive data on multiple psychosocial, dietary, and food-related factors, CVD biological markers, and medical record data, with follow-up at 2-years, and will assess variations by urban-rural area and by timing before-after Maria. PROSPECT builds upon the feasibility and resources established by a 2015 pilot study in PR, and emulates the goals and methods of US and Caribbean cohorts inclusive of mainland Puerto Ricans and other Latinos for comparison. Our specific aims are to: (1) estimate baseline and 2y prevalence of psychosocial, diet and food-related environment, and biological CVD risk factors, (2) determine longitudinal associations between 2y changes in psychosocial factors and biological CVD risk factors, (3) determine longitudinal associations between 2y changes in diet and food-related factors, and biological CVD risk factors, and (4) estimate differences in prevalence and 2y changes in risk factors by urban vs. rural area, and pre vs. post-Maria. PROSPECT will identify priorities for addressing CVD risk factors, and will let us plan and implement tailored public health programs and interventions to effectively improve cardiometabolic health in a high-risk, underserved group. The project will enhance collaborative health research, leadership, and capacity in PR, and has high potential for sustainability by using existing infrastructure, and for comparability with US cohorts. Our new island-wide probabilistic comprehensive longitudinal study will bridge a gap in knowledge in PR, create a biorepository and participant database for future use, yield seminal data to support tailored translation into programs and policy, and compellingly reduce disparities in cardiometabolic health in PR.

项目摘要 尽管努力预防慢性疾病，但它们仍在增加，少数民族服务不足 承担最大的负担。美国（美国）波多黎各领土（PR）的流行率很高 多种心脏代谢条件增加了心血管疾病（CVD）的风险。证据支持 社会心理和与食物有关的环境风险因素以及心脏代谢状况之间的直接联系， 但是，尽管有明确的和 迫切需要减轻岛上慢性病的负担。 2017年9月，玛丽亚飓风 毁灭性的PR，对研究趋势的紧迫性和心脏代谢风险因素的关联 遇险时间下的条件。因此，此应用程序的总体目标是确定趋势和 可以指导公众的心理社会，食物相关和心脏代谢风险因素的纵向关联 健康优先事项和未来的研究需求旨在减少PR中与CVD相关的差异。为此，我们 将建立“前景：波多黎各的心理，环境和慢性的观察性研究 疾病趋势'，是一个全岛，纵向人群，由2,000名成年人（30-75Y）组成的PR招募 概率和社区方法的多帧抽样，并在几个网络中进行评估 整个岛上的合作诊所。该研究将收集有关多个社会心理，饮食的全面数据 以及与食物有关的因素，CVD生物标记和病历数据，并在2年内进行随访，并将 评估城市农村地区的变化以及玛丽亚之前的时间安排。潜在客户建立在可行性的基础上 以及由PR的2015年试点研究建立的资源，并模仿我们的目标和方法 加勒比人队列包括波多黎各大陆和其他拉丁美洲人，以进行比较。 我们的具体目的是：（1）估计基线和与社会心理，饮食和食物相关的2y患病率 环境和生物CVD危险因素，（2）确定2岁变化之间的纵向关联 社会心理因素和生物CVD风险因素，（3）确定2岁之间的纵向关联 饮食和食物相关因素以及生物CVD风险因素的变化，以及（4）估计 城市与农村地区的危险因素的患病率和2岁的变化，以及前与玛丽亚的危险因素。 潜在客户将确定解决CVD风险因素的优先事项，并让我们计划和实施 量身定制的公共卫生计划和干预措施，可有效改善高风险中的心脏代谢健康 服务不足的组。该项目将增强公关的合作健康研究，领导能力和能力，以及 通过使用现有基础设施以及与美国同伙的可比性具有很高的可持续性潜力。 我们全岛范围内的概率综合纵向研究将弥合公关知识的差距， 创建一个生物座席和参与者数据库以供将来使用，产生开创性数据以支持量身定制的翻译 进入计划和政策，并在PR中降低心脏代谢健康的差异。