Risk Factors for Type 2 Diabetes in the Multiethnic Cohort.

OBJECTIVES: In this report, we investigated the association between established risk factors and type 2 diabetes (T2D) across 5 distinct ethnic groups and explored differences according to T2D definition within the Multiethnic Cohort (MEC) Study. METHODS: Using the full MEC, with participants in Hawaii and Los Angeles (N=172,230), we applied Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All participants completed questionnaires asking about demographics, anthropometrics, lifestyle factors, and regular diet. T2D status was determined from self-reported diagnosis/medication and Medicare claims. We assessed the associations between well-established risk factors and T2D in the full cohort, after stratification by ethnic group, according to the T2D definition, and in a biorepository subset. Effect modification by ethnicity was evaluated using Wald's tests. RESULTS: Overall, 46,500 (27%) participants had an incident T2D diagnosis after a mean follow-up of 17.1±6.9 years. All predictors were significantly associated with T2D: overweight (HR=1.74), obesity (HR=2.90), red meat intake (HR=1.15), short (HR=1.04) and long (HR=1.08) sleep duration, and smoking (HR=1.26) predicted a significantly higher T2D incidence, whereas coffee (HR=0.90) and alcohol (HR=0.78) consumption, physical activity (HR=0.89), and diet quality (HR=0.96) were associated with lower T2D incidence. The strength of these associations was similar across ethnic groups with noteworthy disparities for overweight/obesity, physical activity, alcohol intake, coffee consumption, and diet quality. CONCLUSIONS: These findings confirm the importance of known risk factors for T2D across ethnic groups, but small differences were detected that may contribute to disparate incidence rates in some ethnic groups, especially for obesity and physical activity.

Cancer Health Disparities Research Training: A Qualitative Report.

The Research Education Core of the Pacific Islands Partnership for Cancer Health Equity (PIPCHE) conducted a systematic review of participant learning. All students from both the University of Guam and the University of Hawai'i who have completed the program were asked two open-ended questions, which were then thematically analyzed. (1) What impact did the training have on your career? (2) What did you learn about cancer health disparities? Findings include themes such as expanding social networks, building professional skills, providing opportunities and funding, inspiring a future career in research, and giving back to the community. The results also indicate that students learned that cancer disparities research was complex and diverse, required cultural sensitivity, different areas of cancer research and education, the importance of mentor and peer relationships. Trainees spoke very favorably about the weekly seminar format. These findings are consistent with studies in other similar programs. The authors recommend future educational outcome research.