Abstract
Objectives
Many academic medical centers are positioned amidst disadvantaged urban neighborhoods in which healthcare services are underutilized, participation in research studies is low, and need for health improvement is vast. The goal of Temple Health: Block-by-Block (THB3) is to establish a sustainable cohort of Philadelphia residents engaged in individual and community health improvement through health research.
Methods
Recruitment of a population-based sample from 11 Philadelphia zip codes began in August 2015. The cornerstone of the project is the in-home, biannual assessment of each subject.
Results
The first-year goal of 1000 enrolled subjects was met. Greater than 90% of subjects represent minority racial or ethnic groups; average age is 46 years; 65% of subjects have a high school education or less. A high burden of health conditions exists including obesity (54%), smoking (41%), hypertension (44%), and diabetes (17.8%).
Conclusions
THB3 provides a research infrastructure to promote community participation in a health improvement initiative from which future translational research, health education and preventive services will emanate. The launch of this cohort study has provided extensive lessons regarding urban community-based research and health promotion initiatives.
Similar content being viewed by others
References
Agency for Healthcare Research and Quality (2012) National Healthcare Disparities Report 2011 (AHRQ Publication No. 12-0006). Department of Health and Human Services, Rockville, MD
Colditz GA, Philpott SE, Hankinson SE (2016) The impact of the Nurses’ Health Study on population health: prevention, translation and control. AJPH 106(9):1540–1545
Cunningham TJ, Croft JB, Liu Y, Lu H, Eke PI, Giles WH (2017) Vital signs: racial disparities in age-specific mortality among blacks or African-Americans—United States, 1999–2015. Morb Mortal Wkl 66(17):444–452
Department of Public Health (2018) Health of the City. City of Philadelphia
Flynn A, Tremblay P, Rehm J, Wells S (2013) A modified random walk door-to-door recruitment strategy for collecting social and biological data relating to mental health, substance use, addiction and violence problems in a Canadian community. Int J Alcohol Drug Res 2(2):7–16
Galea S, Tracy M (2007) Participation rates in epidemiologic studies. Ann Epidemiol 17:643–653
Heckler MM (1985) U.S. Department of Health and Human Services, Report of the Secretary’s Task Force Report on Black and Minority Health Volume I: executive summary. Government Printing Office, Washington
Hillier A, Cannuscio CC, Griffin L, Thomas N, Glanz K (2014) The value of conducting door-to-door surveys. Int J Soc Res Methodol 17(3):285–302
McCloskey DJ, McDonald MA, Cook J, Heurtin-Roberts S, Updegrove S, Samplson D, Gutter S, Eder M (2011) Community engagement: definitions and organizing concepts from the literature. In: Principles of community engagement, 2nd edn. Center for Disease Control and Prevention. NIH Publication No. 11-7782
O’Mara-Eves A, Brunton G, Oliver S, Kavanagh J, Jamal F, Thomas J (2015) The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta analysis. BMC Public Health 15:129. https://doi.org/10.1186/s12889-015-1352-y
Public Health Management Corporation (2016) Temple University Health System Community Health Needs Assessment, Philadelphia, PA
R Core Team (2013) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. http://www.R-project.org/
Scharff DP, Mathews KJ, Jackson P, Hoffsuemmer J, Martin E, Edwards D (2010) More than Tuskegee: understanding mistrust about research participation. J Health Care Poor Underserved 21(3):879–897. https://doi.org/10.1353/hpu.0.0323
Smedley BD, Stith AY, Nelson AR (eds) (2003) Unequal treatment: confronting racial and ethnic disparities in health care. National Academies Press, Washington
Taylor HA, Wilson JG, Jones DW, Sarpong DF, Srinivasan A, Garrison RJ, Nelson C, Wyatt SB (2005) Toward resolution of cardiovascular health disparities in African Americans: design and methods of the Jackson Heart Study. Ethn Dis 15(4 Suppl 6):S6-4-17
The US Burden of Disease Collaborators (2018) The state of US health, 1990–2016 Burden of diseases, injuries and risk factors among US states. JAMA 319(14):1444–1472
Tsao CW, Vasan RS (2015) Cohort Profile: the Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology. Int J Epidemiol 44(6):1800–1818
U.S. Census Bureau, Partnership and Data Services Branch (2017) American Community Survey. Washington, DC
Acknowledgements
Funding was provided by Temple University (Grant: Strategic Initiative).
Author information
Authors and Affiliations
Contributions
SGF conceived of this study, acquired the financial support and grant funding to support the effort, and directed the development of all data collection tools and study methods. She has written the manuscript and fully approves of the final submitted version. AD developed the implementation tools for subject recruitment, selected and implemented software and databases to coordinate study activities and store data, contributed significantly to survey instrument development, and supervised the field team conducting the data collection. The second author has reviewed and suggested revisions as appropriate to the manuscript, and she has provided approval of the final submitted version.
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any conflict of interest to disclose.
Research involving human subjects
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
As per Institutional Review Board standards, informed consent was obtained from each individual participating in this study. This has also been specified in the manuscript text.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Fisher, S.G., Devlin, A. Development of an urban community-based cohort to promote health disparities research. Int J Public Health 64, 1107–1115 (2019). https://doi.org/10.1007/s00038-019-01267-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-019-01267-4