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. 2013 May 2:72.
doi: 10.3402/ijch.v72i0.20572. Print 2013.

Utilizing harmonization and common surveillance methods to consolidate 4 cohorts: the Western Alaska Tribal Collaborative for Health (WATCH) study

Kathryn R Koller  1 , Abbie W Wolfe, Jesse S Metzger, Melissa A Austin, Scarlett E Hopkins, Cristiane Kaufmann, Stacey E Jolly, Sven O E Ebbesson, Jason G Umans, Barbara V Howard, Bert B Boyer
Affiliations

Utilizing harmonization and common surveillance methods to consolidate 4 cohorts: the Western Alaska Tribal Collaborative for Health (WATCH) study

Kathryn R Koller et al. Int J Circumpolar Health. .

Abstract

Background: According to health status reports, chronic disease prevalence appears to be rising in western Alaska Native (AN) people, and accurate population-based data are needed. Four cohort studies of western AN people were conducted in the Norton Sound and Yukon-Kuskokwim regions, but none have been large enough to allow reliable estimates of rates of chronic diseases and evaluate their risk factors.

Objective: In this article, the methods used to combine 4 major cohort studies of rural western AN people are described and the benefits and challenges encountered in combining data and standardizing surveillance methods for these studies are discussed.

Design: Tribal permission was obtained for each cohort study and the consolidated study. Data from baseline exams were directly combined or harmonized into new variables. Common surveillance methods were developed and implemented to identify incidence and risk factors for cardiovascular disease (CVD) events and type 2 diabetes.

Results: A cohort of 4,569 western AN participants (2,116 men and 2,453 women), aged 18-95 years, was established to study CVD and diabetes prevalence. Prospective surveillance data over an average 6.7-year follow-up can now be used to study CVD and diabetes incidence and associated risk factors in a subset of 2,754 western AN participants (1,218 men and 1,536 women) who consented to initial surveillance.

Conclusions: The combined cohort provides statistical power to examine incidence rates and risk factors for CVD and diabetes and allows for analyses by geographic region. The data can be used to develop intervention programmes in these populations and others.

Keywords: Alaska Native; cardiovascular disease; cohort study; risk factors; statistical power; type 2 diabetes.

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Figures

Fig. 1
Fig. 1
WATCH study data consolidation flow.
Fig. 2
Fig. 2
Comparison of select baseline characteristics in total WATCH cohort and follow-up subset. Note: Smoked=participants who currently or previously smoked cigarettes; FH=family history, DZ=disease, DM=type 2 diabetes, MI=myocardial infarction; HTN=hypertension; HiChol=high cholesterol.
Fig. 3
Fig. 3
Comparison of means for baseline clinical measurements in total WATCH cohort and follow-up subset. Note: SBP=systolic blood pressure (in mmHg); LDL=low-density lipoprotein cholesterol, TG=triglycerides, FPG=fasting plasma glucose, M HDL-C=male high-density lipoprotein cholesterol, and F HDL-C=female high-density lipoprotein cholesterol (all in mg/dL); MWC=male waist circumference; and FWC=female waist circumference (both in centimetres).
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References

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