Neighborhood Characteristics & Diabetes Incidence in Multiethnic Cohort Study

候选人这个指导职业发展奖（K 01）的总体目标是为辛克莱博士提供技能和经验，以建立一个独立的糖尿病相关差异研究计划。这个职业发展奖是基于一个多层次的人口健康概念框架，将先进的教学指导与个性化的一对一的指导相结合。先进的研究培训将有助于促进辛克莱博士的工作，重点是未探索的背景因素，有助于糖尿病的患病率和发病率。该奖项将为她提供时间和工资支持， 发展一个教育基金会和研究计划，扩大她的能力，进行多层次的健康差距研究。为了建立这一基础，培训计划包括三个核心组成部分：1）流行病学，生物统计学，地理信息系统（GIS）技术，空间分析和健康差异研究的正式课程，2）多层次建模和GIS的指导研究培训，以及3）负责研究的指导。辛克莱汇集了一个跨学科的导师委员会，提供广泛的研究经验和她的职业发展计划的支持。K 01奖将使她受益于丰富的多学科指导和培训环境， 包括流行病学、生物统计学、地理信息系统、糖尿病和健康差异研究方面的专家。 研究项目。Sinclair博士建议通过结合个人和地区层面的数据，对多种族队列研究参与者中糖尿病风险因素、患病率和发病率的空间模式和分布进行实证研究。多种族队列研究包括1993年至1996年确定的10万多名夏威夷居民的多样化人口样本，这些居民已被跟踪超过15年。在拟议的项目中，辛克莱博士将在进入队列时对研究参与者的居住地址进行地理编码。社区社会经济地位将根据1990年美国人口普查定义。同样，将确定用于体育活动和获得健康食品的社区资源的措施。研究目的是：1）确定邻居特征与糖尿病患病率和糖尿病的个体水平风险因素（包括肥胖、不良饮食和低水平体力活动）之间的横截面关联，2）评估在调整个体水平糖尿病风险因素后邻居特征与糖尿病发病率之间的纵向关联，以及3）检查邻居特征与糖尿病患病率和发病率之间的关联是否因种族和民族而异。使用多层次的观点可以帮助确定与糖尿病相关的差异相关的因素，并与NIH的战略计划一致，以推动国家走向健康公平。这项研究的结果将阐明造成社区之间健康差异的更大的社会和经济力量，并确定传统和新型公共卫生干预措施可能最有针对性的地理区域。该K 01奖是至关重要的辛克莱博士的未来作为一个糖尿病研究人员，并将为她提供时间，导师，研究技能，分析培训和实践研究经验，发展成为一个独立资助的研究人员在糖尿病预防和控制之间 健康不同的人群。 环境位于Mnoa的夏威夷大学是一个主要的教育和研究机构，是研究和高级研究生和专业学习的中心。UH医学院拥有夏威夷最大的生物医学研究设施，是美国最具文化和种族多样性的医学院，医学院内设有夏威夷原住民健康部，辛克莱博士是研究教师。劳伦斯·N Kolonel，医学博士，博士，将担任辛克莱博士的主要导师。Kolonel博士是UH癌症研究中心的教授，也是多种族队列研究的首席研究员，Sinclair博士将从该研究中得出她的研究项目。癌症研究中心是一个NCI指定的癌症中心，并从癌症中心支持补助金获得资金。该中心的使命是通过研究、教育和服务来减轻癌症的负担，重点是夏威夷和太平洋地区独特的种族、文化和环境特征。目前流行病学计划中有三项队列研究，包括多种族队列研究。辛克莱博士是其中一员，最近成立了一个GIS研究小组，以研究环境因素和癌症发病率。有 癌症中心的几个共享资源，包括夏威夷肿瘤登记处，它是NCI SEER计划的成员;生物统计学，它为研究设计和数据分析提供支持;营养支持，它提供饮食问卷开发方面的专业知识，并维护广泛的食品和补充剂成分数据库;分析实验室，能够分析生物标本和食品的各种成分;一个基因组学实验室，支持遗传易感性和全基因组表达的研究;和一个生物信息学组，支持大型和复杂数据集的管理和分析。虽然教师的研究活动是多种多样的，他们是主题相关的重点， 种族多样性。

Candidate. The overarching goal of this Mentored Career Development Award (K01) is to provide Dr. Sinclair with the skills and experience to establish an independent program of diabetes-related disparities research. This career development award is grounded in a multilevel population health conceptual framework that merges advanced didactic instruction with individualized one-on-one mentorship. The advanced research training will serve to catalyze Dr. Sinclair's work, which focuses on unexplored contextual factors that contribute to diabetes prevalence and incidence. This award will provide her with time and salary support to develop an educational foundation and research program that broadens her capabilities to carry out multilevel health disparities research. To build this foundation, the training program consists of three core components: 1) formal coursework in epidemiology, biostatistics, Geographic Information Systems (GIS) technology, spatial analysis, and health disparities research, 2) mentored research training in multilevel modeling and GIS, and 3) instruction in the responsible conduct of research. Dr. Sinclair brings together an interdisciplinary mentorship board that offers extensive research experience and support of her career development program. The K01 award will allow her to benefit from a rich, multidisciplinary mentorship and training environment, which includes experts in epidemiology, biostatistics, GIS, diabetes, and health disparities research. Research Project. Dr. Sinclair proposes to empirically examine the spatial patterning and distribution of diabetes risk factors, prevalence and incidence among the Multiethnic Cohort Study participants by combining individual- and area-level data. The Multiethnic Cohort Study includes a diverse population-based sample of more than 100,000 Hawaiian residents, identified in 1993-1996, who have been followed for more than 15 years. In the proposed project, Dr. Sinclair will geocode the residential addresses of study participants at the time of entry into the cohort. Neighborhood socioeconomic status will be defined from the 1990 U.S. Census. Similarly, measures of neighborhood resources for physical activity and access to healthy foods will be defined. Research aims are to: 1) determine the cross-sectional association between neighborhood characteristics and the prevalence of diabetes and individual-level risk factors for diabetes, including obesity, poor diet, and low levels of physical activity, 2) assess the longitudinal association between neighborhood characteristics and the incidence of diabetes after adjustment for individual-level diabetes risk factors, and 3) examine if the association between neighborhood characteristics and diabetes prevalence and incidence differs by race and ethnicity. The use of a multilevel perspective can help to identify factors associated with diabetes-related disparities, and is congruent with the NIH strategic plan to move the country toward health equity. Findings from this study will illuminate the larger social and economic forces that create differences in health between neighborhoods, and identify geographical areas where traditional and novel public health interventions may best be targeted. The K01 award is critical to Dr. Sinclair's future as a diabetes researcher and will provide her with the time, mentorship, research skills, analytical training, and practical research experience to develop into an independently funded investigator in diabetes prevention and control among health disparate populations. Environment. The University of Hawaii at Mnoa is a major education and research facility that serves as the center for research and advanced graduate and professional studies. The UH School of Medicine houses the largest biomedical research facility in Hawaii, and is the most culturally and ethnically diverse medical school in the U.S. Housed within the medical school is the Department of Native Hawaiian Health where Dr. Sinclair is a member of the research faculty. Laurence N. Kolonel, MD, PhD, will serve as Dr. Sinclair's primary mentor. Dr. Kolonel is a Professor at the UH Cancer Research Center and Principal Investigator of the Multiethnic Cohort Study from which Dr. Sinclair will draw her research project. The Cancer Research Center is an NCI-designated cancer center and receives funding from a Cancer Center Support Grant. The Center's mission is to reduce the burden of cancer through research, education, and service with an emphasis on the unique ethnic, cultural, and environmental characteristics of Hawaii and the Pacific. There are currently three cohort studies in the Epidemiology Program, including the Multiethnic Cohort Study. A GIS workgroup, of which Dr. Sinclair is a member, was recently formed to examine contextual factors and cancer incidence. There are several shared resources of the Cancer Center including the Hawaii Tumor registry which is a member of NCI's SEER Program; biostatistics which provides support for study design and data analysis; nutrition support which provides expertise in dietary questionnaire development and maintains extensive food and supplement composition databases; an analytical laboratory capable of analyzing biospecimens and foods for a wide array of constituents; a genomics laboratory which supports studies of genetic susceptibilities and whole-genome expression; and a bioinformatics group which supports the management and analysis of large and complex datasets. While the research activities of the faculty are varied, they are thematically related to the focus on ethnic diversity.