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.

项目概要 尽管努力预防慢性病，但慢性病仍在增加，少数族裔得不到充分的服务 承受着最大的负担。美国 (US) 领土波多黎各 (PR) 的患病率很高 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 社会心理和食品相关环境风险因素与心脏代谢状况之间的直接联系， 但在 PR 的全岛人口水平上，这些问题的研究仍然明显不足，尽管有明确和明确的证据 迫切需要减轻岛上慢性病的负担。 2017 年 9 月，飓风玛丽亚 公关遭受重创，迫切需要研究心脏代谢风险因素的趋势和关联 危难时期的状况。因此，该应用程序的总体目标是识别趋势并 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研究需求旨在减少与 CVD 相关的 PR 差异。为此，我们 将建立“前景：波多黎各心理社会、环境和慢性病观察研究” 疾病趋势”，这是一个全岛纵向人群队列，由 2,000 名 PR 成年人（30-75 岁）招募， 概率加社区方法的多帧抽样，并在多个网络中进行评估 全岛的合作诊所。该研究将收集多种心理社会、饮食、 和食品相关因素、CVD 生物标志物和病历数据，并进行 2 年随访，并将 评估城乡地区以及玛丽亚前后时间的变化。前景建立在可行性之上 2015 年公关试点研究建立的资源和资源，并效仿美国和美国的目标和方法 加勒比人群包括波多黎各大陆人和其他拉丁美洲人进行比较。 我们的具体目标是：(1) 估计心理社会、饮食和食物相关的基线和 2 年患病率 环境和生物 CVD 危险因素，(2) 确定 2 年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 危险因素，以及 (4) 估计 城市与农村地区、玛丽亚前后的患病率和危险因素的 2 年变化。 PROSPECT 将确定解决 CVD 风险因素的优先事项，并使我们能够计划和实施 量身定制的公共卫生计划和干预措施，以有效改善高风险、 服务不足的群体。该项目将加强合作健康研究、领导力和公关能力， 通过利用现有基础设施，以及与美国同类企业的可比性，具有很大的可持续性潜力。 我们新的全岛概率综合纵向研究将弥合公关、 创建生物存储库和参与者数据库以供将来使用，产生重要数据以支持定制翻译 纳入计划和政策，并强制减少 PR 中心脏代谢健康的差异。