Asian American Community Cohort and Equity Study (ACCESS)

项目总结 在2000至2020年间，亚裔美国人是美国增长最快的种族群体，从10.5增加到 百万到二千四百万人。到2060年，美国亚洲人的数量预计将上升到4600万，超过 是2000年人口的三倍。尽管亚裔美国人(AA)通常被视为基于 在社会经济和健康指标上，美国人的慢性病发病率实际上接近或超过 美国白人的风险较高，患有多种心脏代谢性疾病的风险较高，尽管 肥胖。但是，由于数据有限，而且报告跨多个AA的聚合数据的常见做法 然而，尽管存在着不同的群体，但存在的差距的真正程度和性质还没有得到很好的理解。因此，要解决 在该领域的重要空白，我们建议建立亚裔美国人社区队列和公平性研究 (通道)横跨费城-新泽西-纽约市地区，其中将包括2400 年龄25岁的男性和女性-来自3个美国亚洲亚裔群体：华人(n=800)，越南(n=800)，以及 菲律宾人(n=800)。我们的多学科团队将利用我们22年来建立的PA-NJ-NYC区域网络 基于社区的协作组织合作伙伴、临床提供者、城市卫生部门和 学术调查人员，以支持队列的基础设施和招募不同的研究参与者 关于出生地、语言和世代地位。与我们尊敬的社区合作 顾问委员会和科学顾问委员会成员，我们的团队在科学方面有着强大和成功的记录 以下方面的生产力和专业知识：1)与AA进行社区参与的纵向队列研究 人群；2)严格评估饮食摄入量和其他健康行为和生活方式因素；3) 健康的社会决定因素(SDoH)和邻里接触的标准化测量；4)收集 用于生物标志物分析的高质量生物样品；以及5)心脏代谢结果的评估 (例如，高血压、2型糖尿病、心血管疾病)。此应用程序的总体目标是 建立严密的接入基础设施，包括正式确定临床/社区合作伙伴关系，开发 队列基础设施，并建立研究协议，以支持全面的标准化收集 心理社会、行为和邻里层面的数据，以及生物显微镜和其他临床检查。这个 拟议的活动与NHLBI的战略愿景密切相关，并将解决关键的研究问题 关于心脏代谢紊乱的患病率在亚裔人群中的差异，如何 SDoH与特定亚群中的疾病风险有关，并与行为和生物识别有关 可解释疾病风险的个体或群体差异的途径。这种协同的多学科 计划建立一个包括3个大型AA亚组的预期综合队列将产生丰富的资源 支持对有助于心脏代谢性疾病风险和健康的多水平途径进行严格研究 在这些规模庞大、不断增长、但未得到充分研究的经历显著差异的人群中取得的成果。

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.