PARENT ABSTRACT (CORE ABSTRACT NOT PROVIDED) The broad objective is to determine prevalence of obesity and type 2 diabetes in Hispanic adolescents. Relationships between these two health problems and factors that contribute to them will be analyzed. Besides providing information to design prevention interventions, this pilot will record baseline data before implementation of a comprehensive children's health program in the school system. After a cohort has encountered this program, the study can be repeated to evaluate its effects. The specific aims of the program are to obtain baseline data, to determine relationships between adiposity, biological markers of type 2 diabetes, behavioral and socioeconomic factors in the development of obesity, to suggest possible prevention interventions, and to use the data to evaluate current and future interventions. The study takes place in Brownsville, on the Texas Mexico border, where the population is 84.8% Hispanic. This community has an average income half that of the rest of the United States, but high disease burdens, particularly chronic diseases such as diabetes. The study population will consist of 474 9th to 12th grade students who are randomly selected. A Type I error level of 0.05, standard deviation of 6.4 BMI units will be assumed and 474 non-respondents will be interviewed. Height, weight, Body Impedance Analysis, blood pressure, acanthosis nigricans, fasting plasma glucose, insulin, lipid profile, C-reactive protein, liver function tests, demographic factors, physical activity and nutritional habits will be recorded. Results from these tests will be shared with the parents of the child. Summary measures (means, median, mode, variability measurements: standard deviation, range, interquartile range, etc.) will be determined. The data will be shared with the Cardiovascular Core for use in evaluation of the effectiveness of their interventions. The Statistical Economic Analysis Core (SEAC) will provide data analyses. A database will contain data from the clinical examination, questionnaire and laboratory. The findings will be analyzed to determine the prevalence of overweight and obese children, type 2 diabetes and association of risk factors. These analyses will be shared with other researchers at the HHRC, with the community, and used to design interventions. A second database will be built to enter data from the non-responder parents.
Screening for Mycobacterium tuberculosis infection in those at high risk for developing clinical tuberculosis (TB) is a key strategy of the Centers for Disease Control and Prevention (CDC) to control the spread of TB in the US. This is particularly important at the US/Mexico border, where converging socioeconomic and demographic factors contribute to the higher burden of TB when compared to the US national average. This region also has high prevalence of type II diabetes (DB), which has long been known to predispose to active tuberculosis. Based on this information, we hypothesize that DB contributes to the burden of TB in the Hispanic population from four Texan counties along the Mexican-American border. Four counties in the Lower Rio Grande Valley (LRGV) will be analyzed in this pilot project: Hidalgo, Cameron, WilIacy and Starr. A secondary analysis of the Texas hospital discharges during 2001 will be implemented using ICD 9 codes for case and control selection. Unconditional multiple logistic regression analysis will be used to evaluate the relationship between tuberculosis and tentative associated factors. Health production functions will be estimated, using unconditional multiple logistic regression as well. The specific aims of the project are: Aim 1: Determine the degree of association of DB and TB in Hispanics in the LRGV Aim 2: Determine the strength of the association between TB and its associated risk factors (besides DB), with emphasis on underlying medical conditions. Aim 3: Estimate health production function that will identify relevant socio-economic indicators of TB and DB.
