Extending a Caribbean Based Cohort to Promote US-Caribbean Comparisons to Facilitate Research Addressing Black Health Disparities

项目概要/摘要 美国50%的非西班牙裔黑人移民来自加勒比地区。因此 美国和加勒比地区人口的健康状况密切相关，这是由于区域接近和高 加勒比移民到美国的数量3.美国和加勒比黑人也分担疾病负担;癌症和 心血管疾病（CVD）是他们最大的健康差异--导致更多黑人死亡 美国和加勒比地区比任何其他民族/种族群体。然而，癌症和心血管疾病的比较 在美国出生的美国黑人和非洲-加勒比地区的子群体之间的研究。虽然NIH已经投资了 在研究美国少数民族/移民人口时，需要与加勒比海的同龄人进行比较，以解开 生物、环境、行为和文化卫生保健系统对心血管疾病和癌症决定因素的影响 风险和结果。非洲加勒比癌症研究所与西印度群岛大学合作， AC 3联盟已经在扩大现有的基于人群的癌症队列方面取得了进展 以及牙买加的CVD研究。牙买加健康和生活方式调查（JHLS-III）于2016-17年进行， 全国代表性样本3000余人。JHLS-III收集了生物样本和流行病学样本， 关于心血管疾病、癌症、其他慢性疾病及其风险因素和病史的数据。据我们所 就目前所知，加勒比地区没有其他具有全国代表性的人口群组， 针对癌症和其他慢性疾病。凭借NCI-P20奖，AC 3，一个NCI-Epidemiology 和基因组学研究计划支持的财团在福克斯大通癌症中心和威斯康星大学已经建立了 加勒比地区心脏代谢疾病和癌症卓越研究中心。这项建议 通过扩展JHLS-III并建立数据挖掘，存储和管理系统， 分析基础设施需要利用和共享来自流行病学措施和生物标本的数据， 促进癌症和心脏代谢疾病的比较研究。这座拟建的基础设施 该项目将为今后的美国-加勒比比较研究利用和准备多层次数据。我们建议 优化加勒比国民在队列研究中的入学率和保留率，方法是：（a） 社区卫生护士/现场工作人员和JHLS-III 2016/17队列参与者的意见和反馈， 完善有针对性的招生和保留战略;和（B）评估这一战略的有效性相对 历史入学率和保留率。我们将重新调整JHLS-III的用途，并将其扩展为一个强大的纵向 由8，000名参与者组成的队列，收集和存储生物标本、社会生态和健康状况数据，以便 回答有关NCD（即癌症和CVD）风险和结果的问题。我们会建立一个安全的数据库 整合和共享平台，使牙买加群组与第三次联合呼吁行动方案研究和其他 加勒比和美国的队列，并进行初步分析，以核实和协调数据。

PROJECT SUMMARY/ABSTRACT Fifty percent of Non-Hispanic Black immigrants in the United States (US) originate from the Caribbean. Thus the health of US and Caribbean populations are closely intertwined due to both regional proximity and the high volume of Caribbean immigration to the US3. US and Caribbean Blacks also share disease burden; cancer and cardiovascular disease (CVD) account for their greatest health disparities-- killing more Black individuals in the US and the Caribbean than any other ethnic/racial group. Yet, there is a paucity of cancer and CVD comparative research between the US-born Black American and African-Caribbean sub-groups. While the NIH has invested in studying US minority/immigrant populations, comparisons with Caribbean cohorts are needed to untangle the effect of biological, environmental, behavioral, and cultural health care system determinants of CVD and cancer risk and outcomes. In partnership with the University of the West Indies (UWI), the African Caribbean Cancer Consortium (AC3) is already making headway into expanding an existing population-based cohort for cancer and CVD research in Jamaica. The Jamaica Health and Lifestyle Survey (JHLS-III), conducted in 2016-17, is a national representative sample of over 3000 persons. The JHLS-III collected bio-specimens and epidemiological data on CVD, cancer, other chronic diseases and their risk factors, and medical history. To the best of our knowledge, there are no other nationally representative population-based cohorts in the Caribbean specifically targeting cancer combined with other chronic diseases. With an NCI-P20 award, the AC3, an NCI-Epidemiology and Genomics Research Program supported consortium at Fox Chase Cancer Center and UWI have established a Caribbean Regional Center of Research Excellence in Cardiometabolic Disease and Cancer. This proposal will be a natural extension of this project by expanding the JHLS-III and building the data mining, storage and analytics infrastructure needed to harness and share data from epidemiological measures and biospecimens to promote comparative research in cancer and cardiometabolic disease. This proposed infrastructure building project will harness and prepare multi-level data for future US-Caribbean comparative studies. We propose to optimize enrollment and retention of Caribbean nationals in cohort studies by (a) obtaining multi-stakeholder input and feedback from community health nurses/field workers and JHLS-III 2016/17 cohort participants to refine targeted enrollment and retention strategies; and (b) evaluating the effectiveness of this strategy relative to historical enrollment and retention rates. We will repurpose and expand the JHLS-III into a robust longitudinal cohort of 8,000 participants, collect and store biospecimens, socioecological and health status data in order to answer questions about NCD (i.e. cancer and CVD) risk and outcomes. We will establish a secure data integration and sharing platform that will enable linkages of the Jamaica cohort with the CAP3 study and other Caribbean and US-based cohorts, and conduct preliminary analytics for data verification and harmonization.