Project 1: Diet and vitamin status, allostatic load, and CVD risk in Puerto Rican adults
This longitudinal cohort study will extend follow-up of our existing cohort of 1500 Puerto Rican adults, aged 45-75 years at baseline, in the Boston area. We will investigate 5-year prospective associations between measures of cardiovascular disease (CVD) risk factors and evidence, in relation to baseline and continuing measures of dietary pattern, vitamin intake and plasma status; assess interrelationships over 5 years of allostatic load, CVD risk and evidence, with consideration of potential modifying effects of dietary pattern and vitamin status; Additionally we will assess associations between neighborhood measures of food availability, and walkability, in relation to dietary pattern, vitamin status, allostatic load, CVD risk factors and evidence.
Project 2: Social and environmental context of cardiovascular risk in Puerto Rican adults
This project is an extension of our sociological investigation of psychosocial stressors and their measurement through 5 years. We will examine these stressors in the context of multilevel analysis, by adding measures of the neighborhood environment. We will assess 5-year prospective interrelationships between depressive symptomatology and psychosocial stress, progression of CVD risk and evidence over 5 years, with consideration of the modifying effects of social networks and social support. We will also assess neighborhood measures of stress (crime, building condition, green space, density, etc) in relation to perceived stress, depressive symptomatology, allostatic load, and measures of CVD risk and evidence.
Project 3: GWAS for cardiovascular health in elderly Puerto Ricans
This project will build on our previous genetic analysis to genotype 1500 Puerto Rican adults currently participating in the Boston Puerto Rican Health Study. We will utilize the genome-wide association study (GWAS) data to target genetic regions for further analysis in relation to CVD risk measures over 5 years, and to 5 year measures of CVD evidence and type 2 diabetes. We will replicate findings observed in this population for CVD risk and type 2 diabetes in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) and Nutrition, Aging, and Memory in Elders (NAME) studies, and complete detailed statistical analyses of specified genes with CVD risk factors, and type 2 diabetes, in interaction with environmental variables, including dietary intake, body weight, physical activity, acculturation and psychosocial stress.
Project 4: A CBPR investigation of traffic pollution and CVD in Puerto Rican adults
This project will conduct environmental monitoring using our mobile air monitoring laboratory at the homes of participants to characterize the ultrafine particulate profile (UFP), test associations between measured levels and roadway proximity and traffic density; and test associations of UFP with inflammatory markers, blood pressure, and CVD risk factors. We will further develop evidence for a causal association between ultrafine particles and adverse outcomes by installing in-home HEPA filters and comparing biomarker concentrations in a double blind, randomized trial. Finally, we will develop and implement a program to educate community members about the risks of exposure to UFP and disseminate information that can be used to reduce exposure.
Project 5: A heart healthy action program for Puerto Rican adults
This intervention project will develop and implement a heart healthy multi-level action program (HAP) for a subset of Puerto Ricans adults in Boston, evaluate the efficacy of the program over two years, and establish a computer-participant working alliance that uses a health behavior automated dialogue (via an embodied conversational agent –ECA) to promote and re-enforce positive heart health behaviors over one year. We will use participatory community-based research via focus groups (community members) and key informant interviews (stakeholders) to inform the development of this program, taking into account individual, social, cultural, and environmental factors that influence health behaviors (diet, physical activity, stress/anxiety, and social isolation) in this population. We will use ethnographic and qualitative techniques to examine the influence of multi-level settings on heart health behaviors and practices and assess baseline and longitudinal associations between the treatment (HAP) vs. comparison group and study outcome variables.