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（由申请人提供）：与美国出生的移民相比，移民的肥胖率通常较低。然而，随着时间的推移，移民的肥胖率上升，并向美国出生的人趋同。移民人数的上升通常归因于文化适应，即采用“美国”的行为和规范。然而，全球化刺激了“美国”商品和做法在世界各地的营销和采用，全球肥胖率正在上升。这些观察结果提出了关于长期趋势的问题，并暗示了如果没有移民，移民是否会增加体重的反事实。 对移民的研究往往无法解决长期趋势和全球变化的问题，因为它们不是这样做的。为了研究这些问题，我们提出了三个具体目标：（1）进行双队列前瞻性跨国研究;（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中介因素和调节因素。 这项研究计划前瞻性地跟踪两组成年人三年。第一批移民（n=800）将从菲律宾到美国。第二批非移民（n=800）将在菲律宾进行随访。双队列设计的使用类似于以移民作为“治疗”的自然实验。“将从参加菲律宾海外委员会（CFO）提供的强制性研讨会的与会者中抽取移民样本，CFO是菲律宾政府机构，负责管理来自该国的所有法律的永久移民。我们与首席财务官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，这提供了以前没有的关于移民的新信息。 移民将从参加强制性首席财务官培训课程的移民名单中抽样。将对居住在菲律宾马尼拉大都会和宿务地区的人进行分层抽样，对非移民进行抽样。非移民将每年进行评估，共4波数据（基线，第1年，第2年，第3年）;移民将以同样的方式进行评估，加上进入美国后2-3个月的额外评估，我们将测量人体测量学，通过干血斑的生物标志物，饮食和身体活动，并进行调查。统计分析将包括线性混合效应模型，以评估随时间变化的轨迹（目标1）、中介分析（目标2）和适度检验（目标3）。我们将使用倾向评分匹配来减少由于混杂而导致的偏倚。 这项研究的结果将提供罕见的和独特的信息移民的移民前的经验，提供严格的长期趋势与文化适应的测试，评估一个新的概念框架，并提供有价值的信息，从中制定预防措施，以减少肥胖和相关疾病的负担在一个重要的移民人口。