Abstract P132: Establishing a New Observational Study of Cardiovascular Risk Factors and Chronic Diseases in Puerto Rico: The PROSPECT Study

Introduction: Evidence supports a direct link between psychosocial and food-related environmental risk factors, and cardiometabolic conditions. These associations remain markedly understudied at the population level in Puerto Rico (PR), despite the clear and pressing need to alleviate striking disparities in chronic disease in the island. On September 2017, Hurricane Maria devastated PR, imposing urgency for studying trends and associations of risk factors for cardiometabolic conditions under times of distress. Hypothesis and aims: We aimed to design and establish ‘PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends’ to study longitudinal associations in psychosocial, food-related, and cardiometabolic risk factors. Methods: PROSPECT was designed as an island-wide, longitudinal population cohort that is recruiting 2,000 adults ages 30-75y using a multi-frame sampling combining probabilistic plus community approaches, with examinations and interviews done in a network of partner clinics across the island. Trained interviewers are collecting comprehensive data on multiple psychosocial, dietary, and food-related factors, cardiovascular disease (CVD) biological markers, and medical record data, with follow-up at 2-years, using standardized protocols and validated questionnaires. PROSPECT emulates the goals and methods of other US and Caribbean cohorts inclusive of mainland Puerto Ricans and other Latinos for comparison. Results: Expected results include estimates of baseline and 2y prevalence and incidence of psychosocial, dietary, and food environment risk factors, and CVD biological markers; measures of associations between 2y changes in risk factors and CVD biological markers; and estimates of differences in prevalence and 2y changes in risk factors, CVD biological markers, and chronic diseases, with emphasis on CVD, by urban vs. rural area, and pre vs. post-Maria. A supplemental study is investigating how food and water shortages following Hurricane Maria may have triggered allostatic load (i.e. physiological stress) and how social connectedness moderates this in PROSPECT participants, with additional context from qualitative narrative interviews. Conclusions: Ultimately, PROSPECT will create a biorepository and participant database for prospective use, and bolster research, academic, and public health partnerships in PR and the US. The study is yielding seminal data to identify priorities on CVD-related disparities, and address them by tailoring public health programs and policy that will effectively improve cardiovascular health in PR, an island with an underserved and high-risk population, under times of distress.