The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort
BMC PUBLIC HEALTH
Authors: Lookens, Jean; Tymejczyk, Olga; Rouzier, Vanessa; Smith, Caleigh; Preval, Fabyola; Joseph, Inddy; Baptiste, Raynold Jean; Victor, Joscar; Severe, Patrice; Apollon, Sandra; Dumont, Emelyne; Forestal, Guyrlaine; Preux, Stephano St.; Rivera, Vanessa; Seo, Grace; Charles, Benedict; Ariste, Wilson; Kingery, Justin; Devieux, Jessy; Koenig, Serena; Nash, Denis; Fitzgerald, Daniel; Safford, Monika; Deschamps, Marie Marcelle; Pape, Jean; McNairy, Margaret
Abstract
Background Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions. Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants. Aim 2: Determine the incidence of CVD risk factors and CVD during 2-3.5 years of follow-up and their association with social and environmental determinants. Methods The Haiti CVD Cohort is a longitudinal observational study of 3000 adults 18 years in Port-au-Prince (PAP), Haiti. The study population is recruited using multistage random sampling from census blocks. Adults receive blood pressure (BP) measurements in the community and those with elevated BP are referred to the Groupe Haitien d'Etude Sarcome de Kaposi et des Infections Opportunistes Clinic for care. After informed consent, participants undergo a clinical exam with medical history. BP, electrocardiogram, echocardiogram, a study questionnaire on health behaviors, and laboratory specimens. Every 6 months, BP is remeasured. At 12 and 24 months, clinical exams and questionnaires are repeated. Labs are repeated at 24 months. Adjudicated study outcomes include the prevalence and incidence of CVD risk factors (hypertension, diabetes, obesity, dyslipidemia, kidney disease, inflammation, poor diet, smoking, and physical inactivity) and events (myocardial infarction, heart failure, stroke, and CVD mortality). We also measure social determinants including poverty. Depression, stress, social isolation, food insecurity, and lead exposure. Blood, urine, and stool samples are biobanked at study enrollment. Discussion The Haiti CVD Cohort is the largest population-based cohort study evaluating CVD risk factors and CVD among adults in urban Haiti with the goal of understanding the drivers of the CVD epidemic in Haiti. Study outcomes are comparable with existing international cohorts, and the biobank will provide important data for future research. Our goal is to translate findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti.
Validation of the mobile verbal learning test: Illustration of its use for age and disease-related cognitive deficits
INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH
Authors: Moore, Raeanne C.; Paolillo, Emily W.; Sundermann, Erin E.; Campbell, Laura M.; Delgadillo, Jeremy; Heaton, Anne; Swendsen, Joel; Depp, Colin A.
Abstract
Objective We developed a mobile cognitive test of verbal learning and memory, the mobile verbal learning test (mVLT), to allow for brief, repeated and portable delivery of a 12-item list learning test through a smartphone. This study examined the psychometric properties of the mVLT among older persons with and without human immunodeficiency virus (HIV). Methods Sixty-eight persons with HIV and 36 HIV-negative individuals (aged 50-74) completed three trials of the mVLT on a smartphone once daily for 14 days. A different word list was administered each day. Results Participants completed 80% of the 14 mVLT administrations, equating to 1166 valid and complete mVLTs. Neither adherence nor mean mVLT total score (number correct in 3 recall trials) differed by HIV status. No practice effects from repeated mVLT administration were observed, and there were moderately strong correlations of mVLT performance with performance on the in-lab version of the task and with traditional cognitive assessments of cognitive processes contributing to memory. We found evidence of within-person learning across mVLT trials, with persons with HIV demonstrating less learning from trials 1 to 3 compared to HIV-negative participants. Conclusions The mVLT is a valid method to assess learning in the real world in older adults with and without HIV.