BPRHS: Boston Puerto Rican Health Study
Study Details
Study Description
Brief Summary
The investigators long-term goal is to understand the complex interactions of diet and other behavioral and environmental factors, genetics, and psychosocial stress on the high and apparently increasing prevalence of cardiovascular disease (CVD) risk factors in Puerto Rican adults.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Puerto Rican adults living on the mainland US have documented health disparities; however, little research has been conducted with this second largest Hispanic subgroup. Our long-term goal is to understand the complex interactions of diet and other behavioral and environmental factors, genetics, and psychosocial stress on the high and apparently increasing prevalence of cardiovascular disease (CVD) risk factors in Puerto Rican adults. As this group is rapidly growing, understanding the reasons for this risk is of great importance. Our initial funding period for the Boston Puerto Rican Center for Population Health and Health Disparities (BPR-CPHHD, 2003-08) focused on the role of stress on physical disability and cognitive decline, through physiological dysregulation or "allostatic load." During that investigation, it became clear that risk factors for CVD were highly prevalent. These findings are in contrast to the commonly held belief that there is a Hispanic paradox--lower heart disease and mortality despite greater poverty. Importantly, the Puerto Rican population differs considerably in ancestral genetic history and in exposures to known risk factors from other Hispanic groups. They have unique dietary intake patterns, as well as social, cultural and environmental structures that contribute and affect reaction to stressors. During our initial funding period, we successfully assembled a cohort of 1500 Puerto Rican adults, aged 45-75 years at baseline, and completed two-year follow-up interviews on more than 1250 participants. As this population is aging and growing rapidly, the high prevalence and apparent cohort effect of increased heart disease risk factors suggest that 1) this population has serious health disparities in heart disease risk factors and 2) heart disease will become an even greater problem for this group in the near future. Our overall aim for this renewal is, therefore, to extend follow-up and to measure and analyze relevant characteristics and CVD risk factors, and to add additional contextual and outcome measures for CVD risk in this established cohort of Puerto Rican adults, so that we may better understand the dynamics of these disparities. Our model follows the transdisciplinary "cells to society" concept developed jointly with our partner CPHHDs during the initial funding period, with consideration of genetic variation in relation to longitudinal change in allostatic load and biochemical indicators of risk; with additional focus on social networks, neighborhood characteristics (physical space and access to food) and environment (air pollution) factors as social determinants of health. Finally, using community based participatory techniques, we will implement and test a multidimensional intervention that focuses on diet and exercise, but that also fully considers the social and physical environment to ensure success. With participation of our community partners, and the support of our administrative, biostatistics and laboratory cores, our team is efficiently poised to make significant contributions to understanding the factors that contribute to the apparent growing threat of heart disease in this highly disadvantaged group-while providing insights that may be useful to other vulnerable groups. The continuation of our cohort, with its rich constellation of measures, will allow us to unravel some of the complex etiologic interactions which contribute to CVD risk, so that effective interventions may be implemented. To date, we have completed approximately 840 5-year follow-up interviews.
Study Design
Outcome Measures
Primary Outcome Measures
- Cardiovascular disease risk [5 years]
Secondary Outcome Measures
- 10-year risk of Coronary Heart Disease (CHD) [5 years]
10-year risk of CHD will be assessed using the Framingham Risk Score
Eligibility Criteria
Criteria
Inclusion Criteria:
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self-identified Puerto Rican decent
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aged 45-75 at baseline
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able to answer questions in English or Spanish
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living in the Boston, MA metropolitan area
Exclusion Criteria:
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unable to answer questions due to serious health conditions
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plan to move away from the area within two years
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Mini Mental State Examination (MMSE) score </=10
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Tufts University | Boston | Massachusetts | United States | 02111 |
| 2 | Northeastern University | Boston | Massachusetts | United States | 02115 |
| 3 | University of Massachusetts Lowell | Lowell | Massachusetts | United States | 01854 |
Sponsors and Collaborators
- University of Massachusetts, Lowell
- National Heart, Lung, and Blood Institute (NHLBI)
- National Institute on Aging (NIA)
- Tufts University
- Northeastern University
Investigators
- Principal Investigator: Katherine L. Tucker, PhD, University of Massachusetts, Lowell
Study Documents (Full-Text)
None provided.More Information
Publications
- Cooper LA, Ortega AN, Ammerman AS, Buchwald D, Paskett ED, Powell LH, Thompson B, Tucker KL, Warnecke RB, McCarthy WJ, Viswanath KV, Henderson JA, Calhoun EA, Williams DR. Calling for a bold new vision of health disparities intervention research. Am J Public Health. 2015 Jul;105 Suppl 3:S374-6. doi: 10.2105/AJPH.2014.302386. Epub 2015 Apr 23.
- Fullerton SM, Anderson EE, Cowan K, Malen RC, Brugge D. Awareness of Federal Regulatory Mechanisms Relevant to Community-Engaged Research: Survey of Health Disparities-Oriented NIH-Funded Investigators. J Empir Res Hum Res Ethics. 2015 Feb;10(1):13-21. doi: 10.1177/1556264614561964. Epub 2014 Dec 10.
- Glik D, Sharif MZ, Tucker KL, Tejada SA, Prelip ML, Ammerman AS, Keyserling TC, Torres SE, Pitts SJ. Community engagement to support cardiovascular disease prevention in disparities populations: three case studies. J Health Dispar Res Pract Apr 2016;9:71-87.
- Orho-Melander M, Melander O, Guiducci C, Perez-Martinez P, Corella D, Roos C, Tewhey R, Rieder MJ, Hall J, Abecasis G, Tai ES, Welch C, Arnett DK, Lyssenko V, Lindholm E, Saxena R, de Bakker PI, Burtt N, Voight BF, Hirschhorn JN, Tucker KL, Hedner T, Tuomi T, Isomaa B, Eriksson KF, Taskinen MR, Wahlstrand B, Hughes TE, Parnell LD, Lai CQ, Berglund G, Peltonen L, Vartiainen E, Jousilahti P, Havulinna AS, Salomaa V, Nilsson P, Groop L, Altshuler D, Ordovas JM, Kathiresan S. Common missense variant in the glucokinase regulatory protein gene is associated with increased plasma triglyceride and C-reactive protein but lower fasting glucose concentrations. Diabetes. 2008 Nov;57(11):3112-21. doi: 10.2337/db08-0516. Epub 2008 Aug 4.
- Paskett ED, Reeves KW, McLaughlin JM, Katz ML, McAlearney AS, Ruffin MT, Halbert CH, Merete C, Davis F, Gehlert S. Recruitment of minority and underserved populations in the United States: the Centers for Population Health and Health Disparities experience. Contemp Clin Trials. 2008 Nov;29(6):847-61. doi: 10.1016/j.cct.2008.07.006. Epub 2008 Jul 31.
- Tucker KL, Mattei J, Noel SE, Collado BM, Mendez J, Nelson J, Griffith J, Ordovas JM, Falcon LM. The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities. BMC Public Health. 2010 Mar 1;10:107. doi: 10.1186/1471-2458-10-107.
- Warnecke RB, Oh A, Breen N, Gehlert S, Paskett E, Tucker KL, Lurie N, Rebbeck T, Goodwin J, Flack J, Srinivasan S, Kerner J, Heurtin-Roberts S, Abeles R, Tyson FL, Patmios G, Hiatt RA. Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities. Am J Public Health. 2008 Sep;98(9):1608-15. doi: 10.2105/AJPH.2006.102525. Epub 2008 Jul 16.
- P50HL105185
- P01AG023394