Asian American Community Cohort and Equity Study (ACCESS)

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PROJECT SUMMARY Between 2000 and 2020, Asian Americans were the fastest growing racial group in the US, increasing from 10.5 million to 24 million individuals. By 2060, the number of US Asians is projected to rise to 46 million, more than triple their 2000 population. Although Asian Americans (AAs) are commonly viewed as a 'model minority' based on socioeconomic and health indicators, AAs actually have chronic disease rates that converge with or exceed those of US whites and are at higher risk for several cardiometabolic disorders despite having lower rates of obesity. However, due to limited data and the common practice of reporting aggregated data across multiple AA subgroups, the true extent and nature of the disparities that exist is not well understood. Thus, to address important gaps in the field, we propose to establish the Asian American Community Cohort and Equity Study (ACCESS) spanning across the greater Philadelphia-New Jersey-New York City region, which will include 2,400 men and women ages 25-64 drawn from 3 US Asian subgroups: Chinese (n=800), Vietnamese (n=800), and Filipino (n=800). Our multidisciplinary team will leverage our 22-year established PA-NJ-NYC Regional Network of collaborative community-based organization partners, clinical providers, city health departments, and academic investigators to support the cohort’s infrastructure and the recruitment of diverse research participants with respect to nativity, language, and generational status. With collaboration from our esteemed Community Advisory Board and Scientific Advisory Board members, our team has a strong and successful record of scientific productivity and expertise in: 1) the conduct of community-engaged longitudinal cohort studies with AA populations; 2) rigorous assessment of dietary intake and other health behaviors and lifestyle factors; 3) standardized measures of social determinants of health (SDoH) and neighborhood-level exposures; 4) collection of high-quality biospecimens for analysis of biologic markers; and 5) assessment of cardiometabolic outcomes (e.g., hypertension, type 2 diabetes, cardiovascular disease). The overall objectives of this application are to establish a rigorous infrastructure of ACCESS including formalizing clinical/community partnerships, developing cohort infrastructure, and establishing study protocols to support the standardized collection of comprehensive psychosocial, behavioral, and neighborhood-level data, along with biospecimens and other clinical exams. The proposed activities are closely aligned with NHLBI’s Strategic Vision and will address key research questions regarding how the prevalence of cardiometabolic disorders varies across Asian ethnic subpopulations, how SDoH relates to disease risk in specific subpopulations, and the identification of behavioral and biologic pathways that may account for individual or group differences in disease risk. This synergistic multidisciplinary plan to establish a prospective comprehensive cohort that includes 3 large AA subgroups will yield a rich resource to support rigorous research on multi-level pathways contributing to cardiometabolic disease risk and health outcomes in these large and growing, but understudied populations that experience significant disparities.