Healthy Aging In Neighborhoods of Diversity Across the Life Span (HANDLS)

一生中多元化社区的健康老龄化 (HANDLS)

• 批准号: 8148266
• 负责人: michele k evans
• 金额: $ 501.18万
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8148266
• 关键词: Longevity; Neighborhoods; healthy aging

The HANDLS study is a prospective, epidemiologic, longitudinal study of a baseline representative sample of African Americans and whites between 30-64 years old recruited as a fixed cohort of participants by household screenings from an area probability sample of twelve census segments in Baltimore City. The HANDLS design is an area probability sample of Baltimore based on the 2000 Census. Using this methodology, working with survey statisticians we chose 12 neighborhoods to meet race by SES by age distribution because they were likely to yield representative distributions of Baltimore City with sufficient individuals to fill the sampling design based. Within the 12 neighborhoods, housing units were selected with a known non-zero chance of selection. The addresses were screened for individuals who meet the age-gender-race-poverty sample size, and those were chosen to be included in the sample using a probability sampling method. From these probabilities, we can compute weights to adjust for unequal probabilities of selection. These weights will be needed to compute estimates that combine subjects across any of the age-gender-race-poverty group. The poverty status delimiter is 125% poverty based on 125% of the 2004 Health and Human Services Poverty Guidelines. The initial examination and recruitment phase took approximately 4 years to complete. The study data was collected in two parts. The first part consisted of an in-home interview that includes questionnaires about the participants health status, health service utilization, psychosocial factors, nutrition, neighborhood characteristics, and demographics. The second part was collected on the medical research vehicles and includes medical history and physical examination, dietary recall, cognitive evaluation, psychophysiology assessments including heart rate variability, arterial thickness, carotid ultrasonography, assessments of muscle strength and bone density, and laboratory measurements (blood chemistries, hematology, biomarkers of oxidative stress and biomaterials for genetic studies). Using our mobile medical research vehicles, we visit each census tract for 4 months and we will re-visit every census tract in a 3.5-year cycle. HANDLS completed its baseline examination wave on March 30, 2009 with a final total accrual of 3722 participants. The cohort is comprised of 2201 African American (59%) and 1523 Whites (41%). Approximately 41% of the cohort reported a household income below the 125% poverty status delimiter. Of those below the 125% poverty delimiter, 13 % were white and 28% African American. Of those above the 125% poverty delimiter, 28% were white and 31% African American. The mean age of the sample was 47.7 years. There were no significant age differences associated with sex or race. Participants below the 125% poverty delimiter were slightly younger than those above the delimiter. HANDLS medical examination rate was 75.2% comparable to the 75% examination rate for the National Health and Nutrition Examination Study (NHANES). Wave 3 examinations started in July 2009. Evaluation of the success of the retention strategy is incomplete but data from the first three neighborhoods to be revisited is promising. Thus far our Interim Re-contact Study (Wave 2) which reaches out to participants approximately 18 months after initial baseline visit completion has been able to re-contact approximately 74% of participants initially seen between 2004 and 2009. The Wave 3 protocol in keeping with the longitudinal study design maintains many of the same study domains as the baseline wave 1 examination including: cognition, cardiovascular disease, nutrition, physical performance, psychology, health services, genomics (genetics and epigenetics), and molecular biomarkers of disease. This protocol also includes new areas of study particularly focused on critical health disparities including, renal function, neuroanatomy, financial and health literacy. These are projects that span a broad range of areas of clinical medicine and include a large number of established minority investigators as well as students and physicians in training.

HANDLS研究是一项前瞻性、流行病学、纵向研究，对30-64岁之间的非裔美国人和白人的基线代表性样本进行研究，通过家庭筛选，从巴尔的摩市12个人口普查部分的区域概率样本中招募固定队列参与者。HANDLS设计是基于2000年人口普查的巴尔的摩区域概率样本。使用这种方法，与调查统计学家合作，我们选择了12个社区，根据社会经济地位和年龄分布来满足种族，因为它们可能产生巴尔的摩市的代表性分布，有足够的个人来填补抽样设计的基础。在12个社区中，住房单元的选择概率为非零。对符合年龄、性别、种族和贫困样本量的个人进行地址筛选，并采用概率抽样方法将其纳入样本。从这些概率中，我们可以计算权重来调整不相等的选择概率。这些权重将用于计算综合任何年龄、性别、种族和贫困群体的受试者的估计。根据2004年《卫生和人类服务贫困准则》的125%，贫困状况的界限为125%。