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

项目总结/文摘

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.