Mexican American
Studies in Houston
Department of Epidemiology
Funded by:
State of Texas Tobacco Settlement Funds
Duncan Family Institute Funds
Caroline W. Law Fund for Cancer Prevention
National Institutes of Health
What is a Cohort?
2001
2003
2006
2009
.. ...
.
Why Mexican-American Studies?
Time Magazine, June 11, 2001
•
•
•
•
Understudied and underserved
Study effect of acculturation (time in US), unique exposures (e.g. pesticides)
Different cancer patterns (e.g. cervix, liver, prostate)
Rate of obesity
Mexican American Cohort Study
Who are eligible
•
Adults of Mexican descent living in Harris or surrounding
counties for at least 1 year
•
•
Household participants must be at least 21 years old
Second participant must live in the household for at least 6
months
What is required
•
•
•
Complete a confidential interview
Donate a small sample of blood, saliva or urine (optional)
Allow us to contact you about every 6 months
Mexican American Cohort Study
Why would someone join
•
Help efforts to assure good health for future generations
•
Health and prevention information provided
•
Health services available in your community
•
Receive $25 gift card (maximum 3 per household)
Study Area: Harris County, TX
Mexican American Cohort Study
Background
• Started in summer of 2001
• Goal is to recruit 50,000 participants (adults) using block
walking, intercept, mail-outs and networking methods
•
Obtain baseline information, such as demographic
information, occupation, acculturation, lifestyle, physical
activity and self and family history of disease
• Obtain biologic samples (blood, saliva, urine), height, weight
• Conduct follow-up of participants every 6-12 months for
health outcomes or to collect other information
Recruitment
As of 5/20/2011
Number
Number of Households
15,303
Number of Participants
Children 5 - <18
Adults  18
22,507
1,191
20,793
Gender
Males
Females
5,189
17,275
Average age years
Children 5 –18
Adults  18
Biological Samples
Blood
Buccal
Missing data may account for total differences
11.0
38.6
12,574
14,581
“Bird’s-Eye” View : Mano A Mano Participants
in Harris County
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NOTE: Map Based on Participants enrolled between Jan. 2003 and June 2009
DNA samples (buccal or blood) have been
obtained from 89% of our participants
About Our Participants…..
Place of Birth
Texas
25%
Other US States
2%
Mexico
73%
About Our Participants…..
Education Level
HS/GED
21%
≤ 8th grade
35%
Post HS Education
18%
9th to11th grade
26%
Comparison of Obesity with Hispanics
from National and State Data
Percent
Self-Reported Diseases by Gender
Cholesterol
Percent
Self-Reported Family History of Disease
by Gender
Cholesterol Attack
Number of Cancers by Gender
Cancer
Men
Women
Baseline Follow-up Baseline Follow-up
Participant:
Breast
Cervical
Uterine
Prostate
127
88
62
27
Family History of cancer:
Breast
6
Uterine
Cervical
Prostate
322
Lung
315
Stomach
185
11
563
357
263
125
192
40
10
8
Website
www.Mano-Mano.us
Examples of
Studies From Cohort
Mexican American Tobacco Use
in Children
Dr. Margaret R. Spitz
•
Predictors of Susceptibility to Smoking in 11-13 year old Mexican-American
adolescents (N = 1,328)
•
•
•
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Acculturation (length of time in US)
Psychosocial/behavioral – socioeconomic, peer/parental influence
Genetics
Hispanic adolescents are more likely to try smoking earlier than other
race/ethnicities
• 6% have one or more friends who smoke
• 35% have a parent or sibling who smokes
•
•
Highest susceptibility rates
Second phase of study beginning March, 2010 (Dr. Anna Wilkinson, UT
Austin)
CASA
Clean Air Safe Air
Promoting Smoke-Free Indoor Air Policy in
Mexican American Households
Primary Investigator
Dr. Alexander Prokhorov MD, PhD.
Department of Behavioral Science
•
Designed to reduce second hand smoke (SHS)
exposure in Mexican Americans
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Increase awareness of health risks associated with
SHS exposure and promoting smoking cessation
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Mexican Americans are a high risk group for
developing SHS-related illnesses and have limited
access to healthcare
Risk Assessment for Mexican
Americans RAMA
Laura Koehly, Ph.D.
National Human Genome Research Institute
&
Anna Wilkinson, Ph.D.
Assistant Professor, Department of Epidemiology
•
•
•
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Family-based intervention to see if families share risk information
Collects family health history information designed by the CDC
Updating family health history
Whether families encourage other family members to screen and adopt
healthful behaviors
• Diseases examined: Heart Disease, Diabetes, Breast & Colon Cancers
Mexican American Nutritional Assessment
Study: MANA
Michele R. Forman, Ph.D., Professor
The Nutritional Epidemiology Working Group
Department of Epidemiology
•
To assess dietary habits in Mexican Americans in the greater Houston
area
•
To examine whether diet varies by age, body size, years in the United
States
•
•
Collect food recalls in Mexican Americans over the year
•
To develop a dietary tool for use in Mexican Americans
Collect spot urine specimens to examine whether markers of diet in
urine are related to the reported diet
Por Nuestra Salud:
Determinants of Smoking Cessation Among SpanishSpeaking Latinos (NCMHD)
David Wetter, PhD
• Longitudinal cohort study designed to examine the process
of smoking cessation and relapse among Spanish-speaking
Latino smokers
•
Participants are followed from two weeks prior to their quit
date through twenty-six weeks post-cessation, and for six
contiguous weeks using ecological momentary assessment
techniques (EMA)
• All participants are provided with nicotine replacement
therapy and counseling
•
Participants are recruited through the Houston-based Mano
a Mano Cohort Study or through other community outlets
Reducing Cancer Disparities Among Latinos in Texas
Principal Investigators: Melissa Bondy, Lovell Jones and
David Wetter (MD Anderson) and Maria Fernandez (UT
SPH)
Purpose: Test Motivation and Problem-solving (MAPS)
intervention for reducing cancer risk related to smoking,
diet and physical activity among Mexican Americans
Area of Study: Houston, El Paso and the Lower Rio Grande
Valley
Methods: Outreach, Research and Training to integrate
knowledge generation, community health education and
community and researcher capacity within and across
three sites.
Collaborations with Other Institutions
UT School of Public Health and the EPA: Study of Hypertension and the
Neighborhood Environment. Elaine Symanski, PhD
Helped recruit Focus Groups first year; then assist with enrollment
future years
University of Houston: Study of Depression in Mothers and Daughters.
Dr. Carla Sharp
Help recruit participants
Baylor College of Medicine:
Help recruit participants for Asthma Study in children.
Dr. Harold Farber
Help recruit participants for study of physical activity in pre-school
children. Dr. Teresia O’Connor