Neighborhood Characteristics and Diabetes Incidence in the Multiethnic Cohort Stu

描述（由申请人提供）：候选人。本次指导职业发展奖（K01）的首要目标是为辛克莱博士提供技能和经验，以建立一个独立的糖尿病相关差异研究项目。这一职业发展奖以多层次人口健康概念框架为基础，该框架将先进的教学指导与个性化的一对一指导相结合。先进的研究培训将有助于催化辛克莱博士的工作，其重点是未被探索的背景因素，有助于糖尿病的患病率和发病率。该奖项将为她提供时间和薪酬支持，以发展教育基金会和研究项目，扩大她开展多层次健康差异研究的能力。为了建立这个基础，培训计划包括三个核心部分：1)流行病学、生物统计学、地理信息系统（GIS）技术、空间分析和健康差异研究的正式课程；2)多层次建模和地理信息系统的指导研究培训；3)负责任的研究指导。辛克莱博士汇集了一个跨学科的指导委员会，为她的职业发展计划提供广泛的研究经验和支持。K01奖将使她受益于一个丰富的、多学科的指导和培训环境，其中包括流行病学、生物统计学、GIS、糖尿病和健康差异研究方面的专家。研究项目。辛克莱博士建议通过结合个体和地区水平的数据，对多民族队列研究参与者中糖尿病危险因素、患病率和发病率的空间模式和分布进行实证研究。这项多民族队列研究包括了一个以不同人群为基础的样本，其中有超过10万名夏威夷居民，于1993年至1996年被确定，他们已经被跟踪了15年以上。在拟议的项目中，辛克莱博士将在进入队列时对研究参与者的居住地址进行地理编码。社区的社会经济地位将根据1990年美国人口普查确定。同样，将确定社区体育活动资源和获得健康食品的措施。研究目的是：1)确定社区特征与糖尿病患病率和糖尿病个人水平危险因素（包括肥胖、不良饮食和低水平体育活动）之间的横断面关联；2)在调整个人水平糖尿病危险因素后，评估社区特征与糖尿病发病率之间的纵向关联。3)研究社区特征与糖尿病患病率和发病率之间的关系是否因种族和民族而异。多层次视角的使用可以帮助确定与糖尿病相关的差异相关的因素，并且与NIH推动国家健康公平的战略计划是一致的。这项研究的结果将阐明造成社区之间健康差异的更大的社会和经济力量，并确定传统和新型公共卫生干预措施可能最适合的地理区域。K01奖对辛克莱博士作为糖尿病研究人员的未来至关重要，并将为她提供时间、指导、研究技能、分析培训和实践研究经验，使她成为一名独立资助的研究人员，在不同健康人群中预防和控制糖尿病。环境。夏威夷大学马诺阿分校是一所主要的教育和研究机构，是研究和高级研究生和专业学习的中心。UH医学院拥有夏威夷最大的生物医学研究机构，也是美国最具文化和种族多样性的医学院。医学院内的夏威夷原住民健康部门是Sinclair博士所在的研究部门。医学博士Laurence N. Kolonel将担任Sinclair博士的主要导师。Kolonel博士是犹他大学癌症研究中心的教授，也是多种族队列研究的首席研究员，辛克莱博士将从该研究中得出她的研究项目。癌症研究中心是NCI指定的癌症中心，并从癌症中心支持拨款中获得资金。该中心的使命是通过研究、教育和服务来减轻癌症的负担，重点是夏威夷和太平洋地区独特的民族、文化和环境特征。流行病学项目目前有三个队列研究，包括多民族队列研究。最近成立了一个GIS工作组，研究环境因素和癌症发病率，辛克莱博士是其中的一员。癌症中心有几个共享资源，包括夏威夷肿瘤登记处，它是NCI的SEER计划的成员；生物统计学为研究设计和数据分析提供支持；营养支持，提供饮食问卷编制方面的专业知识，并维护广泛的食品和补充剂成分数据库；能够分析生物标本和食品中各种成分的分析实验室；支持遗传易感性和全基因组表达研究的基因组学实验室；还有一个支持管理和分析大型复杂数据集的生物信息学小组。虽然教师的研究活动各不相同，但它们在主题上都与对种族多样性的关注有关。2

DESCRIPTION (provided by applicant): Candidate. The overarching goal of this Mentored Career Development Award (K01) is to provide Dr. Sinclair with the skills and experience to establish an independent program of diabetes-related disparities research. This career development award is grounded in a multilevel population health conceptual framework that merges advanced didactic instruction with individualized one-on-one mentorship. The advanced research training will serve to catalyze Dr. Sinclair's work, which focuses on unexplored contextual factors that contribute to diabetes prevalence and incidence. This award will provide her with time and salary support to develop an educational foundation and research program that broadens her capabilities to carry out multilevel health disparities research. To build this foundation, the training program consists of three core components: 1) formal coursework in epidemiology, biostatistics, Geographic Information Systems (GIS) technology, spatial analysis, and health disparities research, 2) mentored research training in multilevel modeling and GIS, and 3) instruction in the responsible conduct of research. Dr. Sinclair brings together an interdisciplinary mentorship board that offers extensive research experience and support of her career development program. The K01 award will allow her to benefit from a rich, multidisciplinary mentorship and training environment, which includes experts in epidemiology, biostatistics, GIS, diabetes, and health disparities research. Research Project. Dr. Sinclair proposes to empirically examine the spatial patterning and distribution of diabetes risk factors, prevalence and incidence among the Multiethnic Cohort Study participants by combining individual- and area-level data. The Multiethnic Cohort Study includes a diverse population-based sample of more than 100,000 Hawaiian residents, identified in 1993-1996, who have been followed for more than 15 years. In the proposed project, Dr. Sinclair will geocode the residential addresses of study participants at the time of entry into the cohort. Neighborhood socioeconomic status will be defined from the 1990 U.S. Census. Similarly, measures of neighborhood resources for physical activity and access to healthy foods will be defined. Research aims are to: 1) determine the cross-sectional association between neighborhood characteristics and the prevalence of diabetes and individual-level risk factors for diabetes, including obesity, poor diet, and low levels of physical activity, 2) assess the longitudinal association between neighborhood characteristics and the incidence of diabetes after adjustment for individual-level diabetes risk factors, and 3) examine if the association between neighborhood characteristics and diabetes prevalence and incidence differs by race and ethnicity. The use of a multilevel perspective can help to identify factors associated with diabetes-related disparities, and is congruent with the NIH strategic plan to move the country toward health equity. Findings from this study will illuminate the larger social and economic forces that create differences in health between neighborhoods, and identify geographical areas where traditional and novel public health interventions may best be targeted. The K01 award is critical to Dr. Sinclair's future as a diabetes researcher and will provide her with the time, mentorship, research skills, analytical training, and practical research experience to develop into an independently funded investigator in diabetes prevention and control among health disparate populations. Environment. The University of Hawaii at Manoa is a major education and research facility that serves as the center for research and advanced graduate and professional studies. The UH School of Medicine houses the largest biomedical research facility in Hawaii, and is the most culturally and ethnically diverse medical school in the U.S. Housed within the medical school is the Department of Native Hawaiian Health where Dr. Sinclair is a member of the research faculty. Laurence N. Kolonel, MD, PhD, will serve as Dr. Sinclair's primary mentor. Dr. Kolonel is a Professor at the UH Cancer Research Center and Principal Investigator of the Multiethnic Cohort Study from which Dr. Sinclair will draw her research project. The Cancer Research Center is an NCI- designated cancer center and receives funding from a Cancer Center Support Grant. The Center's mission is to reduce the burden of cancer through research, education, and service with an emphasis on the unique ethnic, cultural, and environmental characteristics of Hawaii and the Pacific. There are currently three cohort studies in the Epidemiology Program, including the Multiethnic Cohort Study. A GIS workgroup, of which Dr. Sinclair is a member, was recently formed to examine contextual factors and cancer incidence. There are several shared resources of the Cancer Center including the Hawaii Tumor registry which is a member of NCI's SEER Program; biostatistics which provides support for study design and data analysis; nutrition support which provides expertise in dietary questionnaire development and maintains extensive food and supplement composition databases; an analytical laboratory capable of analyzing biospecimens and foods for a wide array of constituents; a genomics laboratory which supports studies of genetic susceptibilities and whole-genome expression; and a bioinformatics group which supports the management and analysis of large and complex datasets. While the research activities of the faculty are varied, they are thematically related to the focus on ethnic diversity. 2 PUBLIC HEALTH RELEVANCE: The NIDDK Mentored Research Scientist Development Award will allow for additional training and mentorship that will position Dr. Sinclair to become an independent investigator. She will need protected time to acquire the comprehensive training in health disparities research and multilevel modeling. Dr. Sinclair's proposed research is may aid in efforts to understand and address the persistent problem of inequalities in health from a multilevel perspective. The proposed research has the potential to move our current understanding of contextual/environmental factors and diabetes forward.