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

项目总结 尽管努力预防慢性病，但慢性病仍在继续增加，少数族裔的服务不足。 担负着最大的负担。美国属地波多黎各(PR)有高患病率。 多种心脏代谢疾病会增加心血管疾病(CVD)的风险。有证据支持 心理社会和与食物有关的环境风险因素与心脏代谢状况之间的直接联系， 但是，在PR的全岛人口层面上，这些问题仍然明显得不到充分的研究，尽管有明确和 迫切需要减轻该岛慢性病的负担。2017年9月，飓风玛丽亚 心力衰竭的公关，迫切需要研究心脏代谢危险因素的趋势和关联 在危难时刻的情况。因此，此应用程序的总体目标是识别趋势和 可指导公众的心理社会、食物相关和心脏代谢危险因素之间的纵向关联 旨在减少公共关系中与心血管疾病相关的差距的健康优先事项和未来研究需求。为此，我们 将建立“前景：波多黎各对心理社会、环境和慢性的观察性研究” 疾病趋势‘，这是一个全岛范围的纵向人口队列，由2,000名成年人(30-75岁)组成，招募了一名 概率加社区方法的多帧抽样，并在几个人的网络中进行评估 遍布全岛的伙伴诊所。这项研究将收集多个心理社会、饮食、 和食品相关因素、心血管疾病生物标记物和病历数据，并将在2年内进行随访 根据城乡地区和玛丽亚前后的时间对变化进行评估。前景建立在可行性之上 和2015年公关试点研究建立的资源，并模仿美国和 加勒比海人群，包括波多黎各大陆人和其他拉美人，用于比较。 我们的具体目标是：(1)估计与心理社会、饮食和食物有关的基线和2年流行率 环境和生物心血管疾病风险因素，(2)决定了两年变化之间的纵向联系 心理社会因素和生物心血管疾病危险因素，(3)决定2y之间的纵向关联 饮食和食物相关因素的变化，以及生物心血管疾病风险因素，以及(4)估计 城市与农村、玛丽亚前后危险因素的患病率和两年变化。 潜在客户将确定解决心血管疾病风险因素的优先事项，并将让我们计划和实施 量身定制的公共卫生计划和干预措施，以有效改善高危人群的心脏代谢健康， 服务不足的群体。该项目将加强合作的卫生研究、领导能力和公关能力，以及 通过利用现有的基础设施，具有很高的可持续性潜力，并具有与美国队列的可比性。 我们新的全岛概率综合纵向研究将填补公关知识的空白， 创建生物信息库和参与者数据库以供将来使用，生成基础数据以支持量身定制的翻译 纳入计划和政策，并强制减少公关中心脏代谢健康方面的差距。

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.