The National Childrens Study in Urban America: The Queens Vanguard Center

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The National Childrens Study in Urban America
The Queens Vanguard Center

• Leo Trasande, MD, MPP
• Queens and Nassau Location Principal Investigator
• NY-NNJ NCS Center
• Assistant Professor of Community Preventive
  Medicine and of Pediatrics
• Mount Sinai School of Medicine

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Disclosures

• No conflicts to disclose.
• Funding N01-HD-5-3411 (Queens Vanguard Center,
  National Childrens Study)

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Queens Vanguard CenterA Consortium of Five
Distinguished Institutions and Key Community
Partnerships
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QUEENS IS ONE OF THE FIVE BOROUGHS OF NYC
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Queens Demographics

• 2000 population 2,229,379 (14.2 increase from
  1990)
• Queens is the most ethnically diverse county in
  the U.S.
• 46 born outside of U.S. (come from over 100
  nations)
• 52 speak a language other than English at home
• 45 Spanish 55 other language
• 71 of babies born in Queens have foreign-born
  mothers
• 24.3 of residents receive some form of public
  assistance
• 14.6 of residents live below poverty level
• Queens covers 71,779.6 acres and 112.2 square
  miles
• 35.8 of land use is one or two family
  residential buildings

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Queens Sample
All Births in Nation
4 million births per year in 3,141 counties
Sample of Study Locations
105 Locations
Sample of Study Segments
Selection of neighborhoods
Study Households
All or a sample of households within neighborhoods
Study Women
All eligible women in the household
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Queens Vanguard Center Local Presence

• Field Offices in Queens
• Long Island City, Queens (Staff Command Center,
  SPSC, SPRC)
• Elmhurst, Queens (Clinic Visit Site SPSC)
• Jamaica, Queens (Clinic Visit Site)
• Additional Facilities for QVC Activities
• Long Island Jewish Hospital
• Clinic visits with LIJ patients
• Will also serve western part of Nassau County
  (Wave 1)
• Addabbo Family Health Center
• Segment 1 (Rockaways)

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Queens Vanguard CenterCommunity Engagement

• Goal To ensure that the communities of Queens
  are aware and familiar with the NCS and that
  their perspectives, interests, and needs are
  represented and used in the planning and
  implementation of the NCS.
• Community Partners Engaged Organizations
• Queens Borough President Helen Marshall
• Queens Community Boards
• Queens Health Coalition
• Queens Comprehensive PrenatalPerinatal Services
  Network
• Clergy United for Community Empowerment
• Joseph P. Addabbo Family Health Center, Inc.
• Eastern Queens Alliance

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Queens Vanguard CenterHospital Engagement

• Goal To ensure that all delivery hospitals are
  identified, engaged, and prepared to have NCS
  staff perform data collection activities during
  birth events.
• Identified 43 delivery hospitals used by women
  living in NCS Queens segments. Engagement
  activities include
• Introductory Meetings
• Administrative MOUs
• IRB Full Reviews, Expedited Reviews, Cooperative
  Agreements
• NCS Staff Credentialing
• Operational Plans for LD and PP Units

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Queens Vanguard Center Institutional Reviews
Approvals
Approvals needed to begin field recruitment
OMB Office of Management and Budget, Executive
Office of the President of the United States IRB
Institutional Review Board NYCDOHMH New York
City Department of Health Mental Hygiene UMDNJ
EOHSI University of Medicine Dentistry of New
Jersey, Environmental Occupational Health
Sciences Institute
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Queens EPSC Segment Roll Out

• Two-Phased Roll Out
• Phase 1 beginning January 2009 (8 segments)
• Phase 2 beginning April 2009 (10 segments)
• Targeted media and community outreach strategies,
  including ethnic media, continued throughout
  recruitment period
• Matched staff and segment demographics

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Recruitment Phase I

• Flushing
• Queensboro Hill
• Kew Garden Hills
• Briarwood
• Long Island City
• Lefrak City
• Elmhurst

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Recruitment Phase II

• Far Rockaway
• Ozone Park
• Bayside
• Ridgewood
• Maspeth
• Elmhurst
• Laurelton
• Hollis
• Queens Village

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QVC Local Materials
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QVC Local Materials

• More than 140 languages spoken in households
  throughout Queens
• Consent, promotional materials translated into
• Spanish
• Chinese
• Korean
• Russian
• Hindi

• Urdu
• Punjabi
• Bengali
• Haitian Creole
• Farsi

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Early Challenges in the Field

• With the best of media and community outreach,
  many households still have not heard about study
  beforehand
• Once the door is opened, enumeration and
  pregnancy screening proceed quickly
• Getting consent for a 21-year study takes
  patience and persistence
• Appropriate concern results in extra effort by
  staff to alleviate concerns including reminder
  that each component of the study is optional

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Upcoming Challenges

• Length and coordination of home visits
• Retention of participants in a highly mobile
  population
• Maintaining community enthusiasm in a long-term
  study
• Coordination of birth visits a special challenge
  given that there are 43 birth hospitals in NYC
  and Nassau County where Queens residents deliver

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Thanks to our Queens Staff!