SHOW-Forward: A pathway for increasing participation, enriching data, and improving access to a unique environmental epidemiology cohort

Well-characterized longitudinal epidemiological cohorts are crucial resources for identifying novel risk factors, examining exposure-outcome associations, and determining the role of biomarkers in disease development and progression. The Survey of the Health of Wisconsin (SHOW) is a unique environmental epidemiological cohort where rigorous survey methodology was used to ensure state-wide participation from Wisconsin, resulting in a representative sample. Based on our successful experience in participant recruitment, we propose to initiate SHOW-Forward to further expand the cohort, enrich already collected data and enhance its access to the research community to facilitate novel environmental epidemiology and translational research aligned with the NIEHS mission. To accomplish these goals, we propose three specific aims. First, we will expand the cohort (renamed as REACH) through continued and enhanced outreach and engagement across Wisconsin. Novel approaches for participant-centric biospecimen collection will be implemented to reduce the burden for participants from remote areas. Second, we will develop a Real-World Data Collaborative infrastructure as a foundation for secure integrative environmental health research and translation. Third, we will establish the administrative infrastructure to develop, refine, and implement ethical and compliant participant recruitment, acquisition, linkage, usage, analysis and sharing of PHI- containing multi-dimensional data and annotated biospecimens in SHOW-Forward. Ultimately, this collaborative infrastructure will facilitate broad access to SHOW data and biospecimens, enable early detection and treatment of emerging health issues, improve understanding of the role of environmental and lifestyle factors, harmful chemical exposures, and genetics on human health, and unlock new pathways for evidence-based prevention of environmentally caused diseases.