Dual-Cohort Prospective Study of Obesity

肥胖双队列前瞻性研究

• 批准号: 9029236
• 负责人: ARNOLD B. DE CASTRO
• 金额: $ 56.59万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9029236
• 关键词: Acculturation; Address; Adopted; Adoption; Adult; Age; American; Area; Behavior; Biological Markers; Blood; Breast; Characteristics; Cholesterol; Cohort Studies; Colon; Communities; Coronary heart disease; Country; Custom; Data; Diet; Education; Emigrant; Emigrations; Epidemic; Exhibits; Filipino; Future; Gallbladder; Global Change; Government Agencies; Health; Immigrant; Learning; Legal; Life; Life Cycle Stages; Literature; Marketing; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; Natural experiment; Nomads; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Participant; Persons; Philippines; Physical activity; Pilot Projects; Population; Preparation; Prevention; Process; Prospective Studies; Proteins; Public Health; Recruitment Activity; Risk; Risk Factors; Sampling; Shapes; Social Network; Socioeconomic Status; Spottings; Stress; Surveys; Testing; Thinking; Time; Training; United States; Waist-Hip Ratio; Weight; Weight Gain; cancer type; cohort; comparison group; design; experience; follow-up; metropolitan; migration; moderate obesity; novel; obesity risk; preference; prospective; public health relevance; sex; social; stressor; trend

 DESCRIPTION (provided by applicant): Immigrants often have lower rates of obesity compared to their U.S. born counterparts. However, over time, rates of obesity rise among immigrants and converge to the U.S. born. This rise among immigrants is often attributed to acculturation, referring to the adoption of "American" behaviors and norms. Yet, globalization has spurred the marketing and adoption of "American" goods and practices across the world, and rates of obesity are rising worldwide. These observations raise questions about secular trends and imply the counterfactual of whether immigrants would have gained weight without migration. Studies of immigrants often fail to address the issues of secular trends and global changes because they are not designed to do so. To study these issues, we propose three specific aims: (1) to conduct a dual- cohort prospective, transnational study; (2) compare changes in obesity risk factors between two cohorts; (3) examine the mediators and moderators of change in obesity risk for both cohorts. This study proposes to prospectively follow two cohorts of adults for three years. The first cohort of migrants (n=800) will be followed from the Philippines to the United States. The second cohort of non-migrants (n=800) will be followed within the Philippines. The use of a dual cohort design is analogous to a natural experiment with migration as the "treatment." Migrants will be sampled from participants attending a mandatory seminar offered by the Commission for Filipinos Overseas (CFO), the Philippines governmental agency that regulates all legal permanent migration from the country. Our unique relationship with the CFO allows us the ability to assess migrants 1-2 months prior to emigration to the U.S. This provides novel information about migrants that have not been previously available. Migrants will be sampled from a list of migrants attending mandatory CFO training sessions. Non- migrants will be sampled using stratified sampling of persons living in the areas of Metropolitan Manila and Cebu, Philippines. Non-migrants will be assessed annually, for a total of 4 waves of data (baseline, year 1, year 2, year 3); migrants will be assessed in the same way, plus one additional assessment 2-3 months after entry into the U.S. We will measure anthropometrics, biomarkers through dried blood spots, dietary and physical activity, and administer a survey. Statistical analyses will include linear mixed effects models to assess the trajectories over time (Aim 1), mediation analyses (Aim 2), and tests of moderation (Aim 3). We will use propensity score matching to reduce bias due to confounding. The results of this study will provide rare and unique information about the pre-migration experiences of emigrants, provide rigorous a test of secular trends versus acculturation, evaluate a novel conceptual framework, and provide valuable information from which to develop prevention efforts to reduce the burden of obesity and related conditions among an important immigrant population.

 描述（由适用提供）：与美国出生的同行相比，移民的肥胖率通常较低。但是，随着时间的流逝，移民的肥胖率上升，并汇聚到美国出生。移民之间的这种兴起通常归因于培养，指的是采用“美国”行为和规范。然而，全球化刺激了全球“美国”商品和实践的营销和采用，肥胖速度在全球范围内正在上升。这些观察结果提出了有关安全趋势的疑问，并暗示了移民是否会增加体重而不会移民的反事实。对移民的研究通常无法解决安全趋势和全球变化的问题，因为它们并非旨在这样做。为了研究这些问题，我们提出了三个具体的目的：（1）进行双重前瞻性，跨国研究； （2）比较两个队列之间肥胖风险因素的变化； （3）检查两个队列肥胖风险变化的介体和主持人。这项研究提议前瞻性地跟随两个成年人三年。第一个移民队列（n = 800）将从菲律宾到美国。菲律宾将遵循第二个非移民队列（n = 800）。双重队列设计的使用类似于自然的迁移实验作为“治疗”。将从参加菲律宾委员会（CFO）的强制性开创性的参与者中取样，该委员会是菲律宾政府机构，该机构规范了所有合法的永久性移民。我们与CFO的独特关系使我们能够在移民到美国之前1-2个月评估移民，这提供了有关以前尚未可用的移民的新信息。移民将从参加强制性CFO培训课程的移民名单中进行采样。非移民将使用居住在菲律宾大都会马尼拉和宿雾地区的人们进行分层采样。每年将评估非移民，总共4个数据波（基线，第1年，第2年，第3年）；移民将以相同的方式进行评估，再加上进入美国后2-3个月的另外评估，我们将通过干血点，饮食和体育锻炼来测量人类学，生物标志物，并进行调查。统计分析将包括线性混合效应模型，以评估随着时间的推移（AIM 1），中介分析（AIM 2）和适度测试（AIM 3）。我们将使用承诺得分匹配来减少由于混淆而减少偏见。这项研究的结果将提供有关移民前移民经历的罕见和独特信息，对世俗趋势与文化的严格测试，评估新颖的概念框架，并提供有价值的信息，从中，从这些信息中，可以从中开发预防努力，以减少重要的移民人群中肥胖和相关条件的燃烧。