1. Mexican American Studies in Houston Funded by: State of Texas Tobacco Settlement Funds Duncan Family Institute Funds Caroline W. Law Fund for Cancer Prevention National Institutes of Health Department of Epidemiology

2. What is a Cohort?... 20032001 20062009...

3. Time Magazine, June 11, 2001 Why Mexican-American Studies? 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

4. 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 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 Mexican American Cohort Study 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 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

5. 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) 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) Mexican American Cohort Study

6. Study Area: Harris County, TX

7. 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 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 Mexican American Cohort Study Background Mexican American Cohort Study Background

8. Recruitment As of 5/20/2011 Recruitment As of 5/20/2011 Number Number of Households15,303 Number of Participants22,507 Children 5 - <181,191 Adults  1820,793 Gender Males5,189 Females17,275 Average age years Children 5 –1811.0 Adults  1838.6 Biological Samples Blood12,574 Buccal14,581 Number of Households15,303 Number of Participants22,507 Children 5 - <181,191 Adults  1820,793 Gender Males5,189 Females17,275 Average age years Children 5 –1811.0 Adults  1838.6 Biological Samples Blood12,574 Buccal14,581 Missing data may account for total differences

9. NOTE: Map Based on Participants enrolled between Jan. 2003 and June 2009

10. DNA samples (buccal or blood) have been obtained from 89% of our participants DNA samples (buccal or blood) have been obtained from 89% of our participants

12. Place of Birth Mexico 73% Texas 25% Other US States 2% About Our Participants…..

13. Education Level ≤ 8th grade 35% 9th to11th grade 26% Post HS Education 18% HS/GED 21% About Our Participants…..

14. Comparison of Obesity with Hispanics from National and State Data

15. Percent Self-Reported Diseases by Gender Cholesterol

16. Percent Self-Reported Family History of Disease by Gender CholesterolAttack

17. CancerMenWomen Participant:Breast 12740Cervical 8810Uterine 628Prostate 2711 Family History of cancer:Breast 6563Uterine 357Cervical 263Prostate 322 Lung315125 Stomach185192 Participant:Breast 12740Cervical 8810Uterine 628Prostate 2711 Family History of cancer:Breast 6563Uterine 357Cervical 263Prostate 322 Lung315125 Stomach185192 Number of Cancers by Gender BaselineFollow-upBaselineFollow-up

18. Website www.Mano-Mano.us Website www.Mano-Mano.us

19. Examples of Studies From Cohort Examples of Studies From Cohort

20. M exican A merican T obacco Use in Ch ildren M exican A merican T obacco Use in Ch ildren Dr. Margaret R. Spitz Predictors of Susceptibility to Smoking in 11-13 year old Mexican-American adolescents (N = 1,328) 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)

21. 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 Increase awareness of health risks associated with SHS exposure and promoting smoking cessation Mexican Americans are a high risk group for developing SHS-related illnesses and have limited access to healthcare

22. Risk Assessment for Mexican Americans Risk Assessment for Mexican Americans RAMA Laura Koehly, Ph.D. National Human Genome Research Institute & Anna Wilkinson, Ph.D. Assistant Professor, Department of Epidemiology 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 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

23. 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 Collect spot urine specimens to examine whether markers of diet in urine are related to the reported diet To develop a dietary tool for use in Mexican Americans

24. Por Nuestra Salud: Determinants of Smoking Cessation Among Spanish- Speaking 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 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

25. 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.

26. 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