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

项目摘要/摘要 在美国，50%的非西班牙裔黑人移民来自加勒比海地区。因此， 美国和加勒比海地区人口的健康状况紧密交织在一起，这既是因为区域接近，也是因为 加勒比海移民美国的数量3。美国和加勒比海黑人也分担疾病负担；癌症和 心血管疾病(CVD)是他们最大的健康差距--导致更多的黑人死亡 美国和加勒比海地区比任何其他族裔/种族群体都要多。然而，癌症和心血管疾病的可比性却很少。 在美国出生的美国黑人和非洲-加勒比亚群之间的研究。而美国国家卫生研究院已经投资了 在研究美国少数民族/移民人口时，需要与加勒比海人群进行比较，以理清 生物、环境、行为和文化卫生保健系统决定因素对心血管疾病和癌症的影响 风险和结果。与西印度群岛大学合作，非洲加勒比癌症 联盟(AC3)在扩大现有的基于人群的癌症队列方面已经取得了进展 和牙买加的心血管疾病研究。牙买加健康和生活方式调查(JHLS-III)于2016-17年度进行，是一项 全国有代表性的样本超过3000人。JHLS-III收集的生物标本和流行病学 关于心血管疾病、癌症、其他慢性病及其风险因素的数据，以及病史。尽我们最大努力 知识，在加勒比地区没有其他具有国家代表性的人口队列 将癌症与其他慢性病结合起来。NCI-P20奖，AC3，NCI-流行病学 和基因组研究计划支持的福克斯·蔡斯癌症中心和UWI联盟已经建立 加勒比心脏代谢性疾病和癌症卓越研究区域中心。这项建议 将是该项目的自然延伸，通过扩展JHLS-III并建立数据挖掘、存储和 需要分析基础设施来利用和共享来自流行病学措施和生物检疫的数据，以 推动癌症和心脏代谢性疾病的对比研究。这项拟议的基础设施建设 该项目将为未来的美国-加勒比比较研究利用和准备多层次的数据。我们建议 通过(A)获得多方利益攸关方，优化队列研究中加勒比国民的招生和保留 来自社区卫生护士/现场工作人员和JHLS-III 2016/17年度队列参与者的意见和反馈 完善有针对性的招生和保留战略；以及(B)评估这一战略的相对有效性 到历史招生和留校率。我们将重新调整JHLS-III的用途并将其扩展为强大的纵向 由8,000名参与者组成的队列，收集和存储生物样本、社会生态和健康状况数据，以便 回答有关非传染性疾病(即癌症和心血管疾病)风险和结果的问题。我们将建立一个安全的数据 整合和分享平台，使牙买加群体能够与第三次缔约方会议研究报告和其他 在加勒比和美国的队列，并为数据核查和协调进行初步分析。

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.