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A Family Affair: Cohort Puts the Health of Mexican-Americans First

Conquest - Fall 2009

By Katrina Burton

Eating the right foods, exercising, minimizing stress and making time in our busy schedules for health-related screenings is not always easy.

Ana Hernandez, the mother of seven children and M. D. Anderson Mexican-American Cohort participant, would have to agree. “But since joining the cohort, taking care of my health, as well as the health of my children, has become really important to me.”

Members of the Hernandez family
gather on the front porch of their East
Houston home. Clockwise: Kimberly
Castillo (far left), who initiated the
process of entering the family into the
Mexican-American Cohort, Genevieve,
Ana, Gwendolyn, granddaughter
Clarissa and Jesus (far right).

The Hernandez family is one of many families who have joined the cohort — an epidemiologic health study that follows individuals over time.

Initiated eight years ago, the goal of the study has been to gather significant data that will help identify potential health risks for Mexican-Americans living in Houston.

“This population is not only underserved but understudied,” says Margaret Spitz, M.D., former chair of the Department of Epidemiology at M. D. Anderson.

Under the leadership of Melissa Bondy, Ph.D., professor in the Department of Epidemiology, director of the Childhood Cancer Epidemiology and Prevention Center and principal investigator on the Mexican-American Cohort, the Mano-a-Mano health study has recruited more than 19,000 families to follow. With the help of co-investigator Michele Forman, Ph.D., also a professor in the Department of Epidemiology, and a league of researchers and coordinators, this resource will help researchers estimate — and ascertain causes related to — disease incidence and mortality in the Mexican-American population.

Participants agree to be followed throughout the study, during which detailed epidemiologic information, biologic samples and information on family health is collected and analyzed.

“The data collected will allow us to identify behavioral and genetic risk factors that will help us disseminate specific cancer prevention strategies for that population,” Bondy says.

Mano-a-Mano is currently the largest long-term health study of Mexican-Americans in the United States. With such a large number of participants, it has paved the way for other funded studies.

Building a smoke-free future

One of the first studies implemented under the cohort was the “Mexican-American Tobacco Use in Children” (MATCh) study conducted by M. D. Anderson researchers. Funded by a grant from the National Cancer Institute, the study explored experimentation with cigarette smoking in children of Mexican origin, who were 11 to 13 years old when the study began.

“We wanted to collect longitudinal data on children to determine the role of acculturation in smoking initiation. We were also interested in evaluating how psychosocial factors, socioeconomic status, peer influences and genetic make-up contributed to adolescent smoking,” says Spitz, principal investigator on the MATCh study.

Results published in the Journal of Adolescent Health indicate that certain adolescents may view behaviors such as smoking as a way to achieve higher status and thereby increase their peer social standing.

Through research and multiple publications in scientific journals, MATCh is providing the scientific community with invaluable opportunities to conduct further research on other specific lifestyle behaviors of young adolescents in the Mexican-American community, including alcohol use, diet and level of physical activity.

A look in the mirror

The Risk Assessment for Mexican-Americans (RAMA) project, funded by the National Human Genome Research Institute and completed under the umbrella of the Mexican-American Cohort, is a family-based intervention that examines the effectiveness of taking a family-centered approach to communicating disease risk information.

“For the Mexican-American community, the family provides an important setting through which people interpret and share health information and formulate strategies to engage in health-promoting behaviors,” says Laura Koehly, Ph.D., investigator at the National Institutes of Health and principal investigator on the RAMA study.

With an ultimate aim toward prevention
of ill health, researchers on the Mexican-
American Cohort seek to understand
the effects of the Houston environment
on local inhabitants, such as members
of the Hernandez family who live near
an oil refinery.

Not only does RAMA investigate how families communicate about their risk for common and complex diseases, but it also provides an opportunity to study how different types of feedback might motivate participants to address their risks for the diseases studied.

“In this study we want to see if providing risk assessment information coupled with behavioral change messages motivates people to change their behavior more than simply providing information about their risks alone,” says Anna Wilkinson, Ph.D., assistant professor in the Department of Epidemiology and M. D. Anderson’s principal investigator on the study.

Through the generosity of the Duncan Family Institute, M. D. Anderson will expand recruitment efforts to Mexican-Americans living in other areas of Harris County and add the collection of dietary habit information. The institute’s support to strengthen the cohort ensures that new questions about cancer-risk factors in this population can be asked and answered with the ultimate goal of helping people like Ana Hernandez take care of their health.

© 2015 The University of Texas MD Anderson Cancer Center