Dual-Cohort Prospective Study of Obesity

肥胖双队列前瞻性研究

• 批准号: 9029236
• 负责人: ARNOLD B. DE CASTRO
• 金额: $ 56.59万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9029236
• 关键词: Acculturation; Address; Adopted; Adoption; Adult; Age; American; Area; Behavior; Biological Markers; Blood; Breast; Characteristics; Cholesterol; Cohort Studies; Colon; Communities; Coronary heart disease; Country; Custom; Data; Diet; Education; Emigrant; Emigrations; Epidemic; Exhibits; Filipino; Future; Gallbladder; Global Change; Government Agencies; Health; Immigrant; Learning; Legal; Life; Life Cycle Stages; Literature; Marketing; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; Natural experiment; Nomads; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Participant; Persons; Philippines; Physical activity; Pilot Projects; Population; Preparation; Prevention; Process; Prospective Studies; Proteins; Public Health; Recruitment Activity; Risk; Risk Factors; Sampling; Shapes; Social Network; Socioeconomic Status; Spottings; Stress; Surveys; Testing; Thinking; Time; Training; United States; Waist-Hip Ratio; Weight; Weight Gain; cancer type; cohort; comparison group; design; experience; follow-up; metropolitan; migration; moderate obesity; novel; obesity risk; preference; prospective; public health relevance; sex; social; stressor; trend

 DESCRIPTION (provided by applicant): Immigrants often have lower rates of obesity compared to their U.S. born counterparts. However, over time, rates of obesity rise among immigrants and converge to the U.S. born. This rise among immigrants is often attributed to acculturation, referring to the adoption of "American" behaviors and norms. Yet, globalization has spurred the marketing and adoption of "American" goods and practices across the world, and rates of obesity are rising worldwide. These observations raise questions about secular trends and imply the counterfactual of whether immigrants would have gained weight without migration. Studies of immigrants often fail to address the issues of secular trends and global changes because they are not designed to do so. To study these issues, we propose three specific aims: (1) to conduct a dual- cohort prospective, transnational study; (2) compare changes in obesity risk factors between two cohorts; (3) examine the mediators and moderators of change in obesity risk for both cohorts. This study proposes to prospectively follow two cohorts of adults for three years. The first cohort of migrants (n=800) will be followed from the Philippines to the United States. The second cohort of non-migrants (n=800) will be followed within the Philippines. The use of a dual cohort design is analogous to a natural experiment with migration as the "treatment." Migrants will be sampled from participants attending a mandatory seminar offered by the Commission for Filipinos Overseas (CFO), the Philippines governmental agency that regulates all legal permanent migration from the country. Our unique relationship with the CFO allows us the ability to assess migrants 1-2 months prior to emigration to the U.S. This provides novel information about migrants that have not been previously available. Migrants will be sampled from a list of migrants attending mandatory CFO training sessions. Non- migrants will be sampled using stratified sampling of persons living in the areas of Metropolitan Manila and Cebu, Philippines. Non-migrants will be assessed annually, for a total of 4 waves of data (baseline, year 1, year 2, year 3); migrants will be assessed in the same way, plus one additional assessment 2-3 months after entry into the U.S. We will measure anthropometrics, biomarkers through dried blood spots, dietary and physical activity, and administer a survey. Statistical analyses will include linear mixed effects models to assess the trajectories over time (Aim 1), mediation analyses (Aim 2), and tests of moderation (Aim 3). We will use propensity score matching to reduce bias due to confounding. The results of this study will provide rare and unique information about the pre-migration experiences of emigrants, provide rigorous a test of secular trends versus acculturation, evaluate a novel conceptual framework, and provide valuable information from which to develop prevention efforts to reduce the burden of obesity and related conditions among an important immigrant population.

 描述（由申请人提供）：与在美国出生的婴儿相比，移民的肥胖率通常较低，但是，随着时间的推移，移民的肥胖率会上升，并与美国出生的婴儿趋同。移民的肥胖率上升通常归因于文化适应。然而，全球化刺激了“美国”商品和做法在世界各地的营销和采用，全球肥胖率正在上升，这些观察结果引发了人们对长期趋势和习惯的质疑。暗示了移民的体重是否会在没有移民的情况下增加的反事实现象。对移民的研究往往无法解决长期趋势和全球变化的问题，因为它们的目的并非如此。为了研究这些问题，我们提出了三个具体目标：（1） ）进行双队列前瞻性跨国研究；（2）比较两个队列之间肥胖风险因素的变化；（3）检查两个队列肥胖风险变化的中介因素和调节因素。成人的三年。第一批移民（n = 800）将在菲律宾境内进行跟踪，第二批非移民（n = 800）将在菲律宾境内进行跟踪。移民是从参加由菲律宾海外委员会（CFO）举办的强制性研讨会的参与者中抽取的，该委员会是菲律宾政府机构，负责监管所有合法的永久移民。我们与菲律宾的独特关系。首席财务官使我们能够在移民到美国之前 1-2 个月对移民进行评估。这提供了以前无法获得的有关移民的新信息。移民将从参加强制性 CFO 培训课程的移民名单中抽取。每年对居住在菲律宾马尼拉大都会和宿务地区的非移民进行分层抽样，总共评估 4 波数据（基线、第一年、第二年、第三年）；移民将以同样的方式进行评估，并在进入美国后 2-3 个月进行一次额外评估。我们将通过干血斑、饮食和身体活动来测量人体测量学、生物标志物，并进行一项包括线性混合效应的统计分析。我们将使用倾向评分匹配来减少由于混杂因素造成的偏差。提供有关移民移徙前经历的罕见且独特的信息，对长期趋势与文化适应进行严格的测试，评估新颖的概念框架，并提供有价值的信息，以制定预防工作，以减轻肥胖和相关疾病的负担重要的移民人口。