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: 10218260
• 负责人: JOSIEMER MATTEI
• 金额: $ 62.37万
• 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 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10218260
• 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; 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 population; 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 尽管为预防慢性病做出了努力，但慢性病仍在增加， 承受着最大的负担。美国（US）领土波多黎各（PR）的以下疾病患病率较高： 增加心血管疾病（CVD）风险的多种心脏代谢状况。有证据表明， 社会心理和食物相关的环境风险因素与心脏代谢疾病之间的直接联系， 但这些仍然明显不足，在全岛人口水平的公关，尽管明确和 迫切需要减轻岛上慢性病的负担。2017年9月，飓风玛丽亚 破坏了PR，迫切需要研究心脏代谢危险因素的趋势和关联， 在危难时刻的条件。因此，该应用程序的总体目标是确定趋势， 心理社会、食物相关和心脏代谢风险因素的纵向关联，可以指导公众 健康优先事项和未来的研究需求，旨在减少CVD相关的PR差异。为此，我们 将建立“前景：波多黎各的社会心理、环境和慢性 疾病趋势“，一个全岛范围内的2,000名PR成年人（30- 75岁）的纵向人群队列， 多帧抽样的概率加社区的方法，并在一个网络的几个评估 全岛各地的合作诊所。这项研究将收集关于多种心理社会，饮食， 和食物相关因素、CVD生物标志物和病历数据，随访2年，并将 评估城市-农村地区和玛丽亚前后时间的变化。前景建立在可行性之上 2015年在公关试点研究建立的资源，并模仿美国的目标和方法， 包括波多黎各大陆人和其他拉丁美洲人在内的加勒比队列进行比较。 我们的具体目标是：（1）估计基线和2年患病率的心理社会，饮食和食物相关的 环境和生物CVD危险因素，（2）确定2 y变化之间的纵向关联， 心理社会因素和生物CVD危险因素，（3）确定2年之间的纵向关联 饮食和食物相关因素的变化，以及生物CVD风险因素，以及（4）估计 按城市与农村地区以及玛丽亚前后分列的患病率和风险因素的2年变化。 前景将确定解决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，以有效改善高风险人群的心脏代谢健康， 服务不足的群体该项目将加强合作健康研究，领导和公关能力， 通过使用现有基础设施，具有很高的可持续性潜力，并与美国同类产品具有可比性。 我们新的全岛概率综合纵向研究将弥合公关知识的差距， 创建生物库和参与者数据库供将来使用，产生种子数据以支持定制翻译 纳入方案和政策，并强制性地减少PR中心脏代谢健康的差异。