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

HANDLS研究是一项前瞻性、流行病学、纵向研究，以30岁至之间的非裔美国人和白人为基线代表性样本，通过家庭筛查从巴尔的摩市12个人口普查区段的区域概率样本中招募作为固定队列参与者。HANDLS设计是巴尔的摩基于2000年人口普查的面积概率样本。使用这种方法，与调查统计学家合作，我们选择了12个社区，按年龄分布满足SES的种族要求，因为它们可能产生巴尔的摩市的代表性分布，具有足够的个人来填充基于抽样设计的基础。在这12个社区中，住房单元的选择机会是已知的非零。对符合年龄-性别-种族-贫困样本大小的个人地址进行筛选，并使用概率抽样方法选择那些被包括在样本中的个人。根据这些概率，我们可以计算权重，以调整不相等的选择概率。这些权重将被用来计算结合任何年龄、性别、种族和贫困群体的受试者的估计。根据2004年《卫生和公共服务贫困准则》的125%，贫困状况的分界线是125%的贫困。 初步考试和招聘阶段将需要大约4年的时间才能完成。研究数据分两部分收集。第一部分是家庭访谈，包括对参与者的健康状况、卫生服务利用、心理社会因素、营养、社区特征和人口统计学的问卷调查。第二部分是在医学研究工具上收集的，包括病史和体检、饮食回忆、认知评估、心理生理学评估，包括心率变异性、动脉厚度、颈动脉超声、肌肉力量和骨密度评估，以及实验室测量(血液化学、血液学、氧化应激生物标记物和用于基因研究的生物材料)。最终，HANDLS的基线样本将包括大约4,000名居住在社区的非洲裔美国人和白人成年人，年龄在30-之间。使用我们的移动医疗研究车辆，我们将在4个月内访问每个人口普查区域，并将在3.5年的周期中重新访问每个人口普查区域。 到目前为止，HANDLS已经在巴尔的摩南部、水库山、樱桃山、戈瓦斯、森林公园、高地城、莫雷尔公园、柯蒂斯海湾、公园高地、法兰克福、南希尔顿和巴尔的摩彭罗斯社区招募了3182名参与者。这大约是计划总人数的80%，特别是3182名参与者：1,977名非裔美国人(62%)和1205名白人(38%)。约45%的队列报告家庭收入低于125%的贫困状况分界线。在125%的贫困线以下的人中，31%是白人，69%是非裔美国人。在125%的贫困线以上的人中，44%是白人，56%是非裔美国人。样本的平均年龄为47.9岁。性别或种族方面没有显著的年龄差异。低于125%贫困分界线的参与者比超过125%贫困分界线的参与者略年轻。 协变量：其他变量包括营养、环境和邻里效应、遗传构成、家族史、活动水平、获得医疗保健的机会，以及普遍存在的医疗、牙科、精神疾病、氧化应激和DNA修复能力，这些因素可能调节SES和种族对心血管、肌肉骨骼、认知和自主神经功能的影响。

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 are selected with a known non-zero chance of selection. The addresses are 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 will take approximately 4 years to complete. The study data is being collected in two parts. The first part consists 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 is 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). Ultimately, the baseline HANDLS sample will consist of approximately 4,000 community-dwelling African American and white adults aged 30-64. 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. Thus far HANDLS has recruited 3182 participants in the South Baltimore, Reservoir Hill, Cherry Hill, Govans, Forest Park, Highlandtown, Morrell Park, Curtis Bay, Park Heights, Frankford, South Hilton and Penrose neighborhoods of Baltimore. This is approximately 80% of the planned total cohort, specifically 3,182 participants: 1,977 African Americans (62%) and 1,205 whites (38%).Approximately 45% of the cohort reported a household income below the 125% poverty status delimiter. Of those below the 125% poverty delimiter, 31% were white and 69% African American. Of those above the 125% poverty delimiter, 44% were white and 56% African American. The mean age of the sample was 47.9 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. Covariates: Other variables include nutrition, environment and neighborhood effects, genetic make-up, family history, activity level, access to health care, and prevalent medical, dental, psychiatric conditions, oxidative stress, and DNA repair capacity which may modulate the effects of SES and race on cardiovascular, musculoskeletal, cognitive, and autonomic functioning.