The Pacific Ocean Native Observational (PONO) Health Legacy Study

太平洋原住民观测 (PONO) 健康遗产研究

• 批准号: 10724217
• 负责人: Marjorie K. Leimomi Mala Mau
• 金额: $ 58.37万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10724217
• 关键词: Address; Age; Age Years; Age of Onset; Asian Americans; Behavior; Behavioral; Biological; Biological Factors; Blood; Body mass index; Cardiopulmonary; Cardiovascular Diseases; Cause of Death; Chronic Disease; Chronic Obstructive Pulmonary Disease; Clinic Visits; Clinical; Clinical Research; Cohort Studies; Collaborations; Communities; Complex; Data; Data Reporting; Diabetes Mellitus; Diet; Disease; Disease Outcome; Disparity; Electronic Health Record; Enrollment; Environmental Exposure; Enzyme-Linked Immunosorbent Assay; Epidemiology; Ethnic Origin; Family; Feces; Federally Qualified Health Center; Future Generations; Generations; Genetic; Glycosylated hemoglobin A; Goals; Hawaii; Health; Health Disparities Research; Health behavior; Heterogeneity; Home; Household; Immunologics; Incidence; Individual; Inflammation; Institutional Racism; Intervention Studies; Investments; Knowledge; Life Style; Longevity; Longitudinal Studies; Measures; Mediating; Medical; Metabolic; Metabolic Diseases; Methodology; Native Hawaiian; Native Hawaiian or Other Pacific Islander; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Observational Study; Outcome; Outcome Measure; Pacific Islander; Pacific Ocean; Participant; Periodicals; Persons; Phase; Physical activity; Population; Prevalence; Process; Protocols documentation; Pulmonary Heart Disease; Questionnaires; Race; Recording of previous events; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Sample Size; Severities; Smoking; Social Network; Technology; Testing; Time; Tissues; Trauma; Universities; Urine; Variant; Visceral; Visit; Work; age group; biobank; blood-based biomarker; cohort; community engagement; community organizations; data standards; diabetes risk; early onset; epigenomics; ethnic diversity; follow-up; gene environment interaction; health disparity; health inequalities; immune function; innovation; microbiome; mortality; multi-racial; novel; population based; prospective; psychosocial; racial population; recruit; resilience factor; sample collection; sex; social; social health determinants; socioenvironmental factor

PROJECT SUMMARY Hawai‘i is the most ethnically diverse state in the US. Native Hawaiians (NH), Pacific Islanders (PI) and Asian Americans (AsA) account for nearly 70% of the state’s population & it is home to >50% of all NHPI in the US. This UG3/UH3 proposal will establish a new prospective, multi-generational cohort to investigate cardiopulmonary & metabolic (CPM) health among NH & Micronesian PI in Hawai‘i. These 2 distinct, yet understudied, sub-populations have an excess burden of CPM disease outcomes. Diabetes mellitus (DM) occurs in 28% and preDM in 37% of NHPI (>20y.o.), suggesting >50% of NHPI have or are at-risk for DM. CVD mortality is 4-fold higher in NHPI with DM compared with nonDM. CVD mortality is the leading cause of death among NHPI. Despite decades of clinical & intervention studies among NHPI, CPM health inequities remain largely unchanged & is increasing among younger NH and PI people. Our proposal, the Pacific Ocean Native Observational (PONO) Health Legacy Study, will directly confront methodological challenges (i.e. racial aggregation, small sample size, etc.) of prior NHPI studies & will conduct innovative, technology-driven “populomics” approaches to change the course of CPM health disparities among NH & PI. Our approach builds on a strong interdisciplinary team of scientific & community-based leaders who bring decades of community, clinical, epidemiological & epigenomic expertise. We will work closely with the Coordinating Center to maximize the overall AsA-NHPI cohort’s ability to conduct studies of multiple hypotheses testing. Our specific aims (S.A.) are as follows: S.A.#1 (UG3): Establish a prospective, community-engaged, multi-generational population-based cohort study of 2,500 Native Hawaiians and Pacific Islanders in Hawai‘i. Our longstanding partnerships with clinical & community-based groups are primed & enthusiastic to recruit, retain & conduct standardized data & biological specimen collection that will invest in the health of future generations. S.A. #2 (UH3): Characterize the relationship of risk and resilience factors with clinical blood-based biomarkers of metabolic and immunologic function relevant to CPM conditions. Determine prevalence of CPM subclinical disease & conduct association studies of multi-level risk & resilience factors by CPM conditions. S.A. #3 (UH3): Assess the impact of CPM-associated risk and resilience factors on incident CPM- outcomes measured over time between Hawai‘i and continental populations of NH and PI in the AsA- NHPI cohort study. Determine incidence of CPM outcomes associated with multi-level risk/resilience factors & to compare data with relevant subpopulations in the overall AsANHPI cohort. The overall impact of the PONO study is its potential to transform health disparity research through novel “populomics” approaches in a representative population of AsANHPI in the US.

项目摘要 夏威夷是美国种族最多样化的州。夏威夷原住民（NH），太平洋岛民（PI）和亚洲人 美国人（阿萨）占该州人口的近70%，也是美国所有NHPI的50%以上。 该UG 3/UH 3提案将建立一个新的前瞻性多代队列， 心肺和代谢（CPM）健康之间的NH和夏威夷PI。这两个不同的，但 研究不足，亚群有CPM疾病结果的过度负担。糖尿病（DM） NHPI（> 20岁）中28%发生糖尿病，37%发生糖尿病前期，提示>50%的NHPI患有DM或有DM风险。 NHPI合并DM患者的CVD死亡率是非DM患者的4倍。心血管疾病死亡率是导致 NHPI死亡。尽管在NHPI中进行了数十年的临床和干预研究，但CPM健康不平等 在很大程度上保持不变，并且在年轻的NH和PI人群中增加。我们的提议，太平洋 本土观察性（PONO）健康遗产研究将直接面临方法学挑战（即， 种族聚集、样本量小等）之前的NHPI研究，并将进行创新，技术驱动 “人口组学”的方法来改变NH和PI之间的CPM健康差距的过程。我们的方法建立 在一个强大的跨学科团队的科学和社区为基础的领导者谁带来了几十年的社区， 临床、流行病学和表观基因组学专业知识。我们将与协调中心密切合作， 最大限度地提高AsA-NHPI队列进行多假设检验研究的能力。我们的具体 aims（S.A.）如下所示： S.A.编号1（UG 3）：建立一个前瞻性的、社区参与的、多代人口为基础的 对2,500名夏威夷土著人和太平洋岛民进行的队列研究。我们长期的合作伙伴关系 与临床和社区为基础的团体准备和热情招募，保留和进行标准化 数据和生物标本收集将投资于后代的健康。 S.A. #2（UH 3）：描述风险和弹性因素与基于临床血液的 与CPM状况相关的代谢和免疫功能的生物标志物。确定以下疾病的患病率 CPM亚临床疾病及CPM多水平风险与恢复力因素的关联研究 条件 S.A. #3（UH 3）：评估CPM相关风险和弹性因素对事件CPM的影响- 在阿萨的NH和PI的夏威夷和大陆人群之间随时间测量的结果- NHPI队列研究。确定与多水平风险/弹性因素相关的CPM结果的发生率& 将数据与整个AsANHPI队列中的相关亚群进行比较。 PONO研究的总体影响是其通过以下方式改变健康差异研究的潜力： 在美国AsANHPI的代表性人群中采用新型“人口组学”方法。