Cruz Nazario, PhD
Staff Affiliate - OtherAbout
Research
Publications
2025
Diabetes prevention in the Caribbean using lifestyle intervention and Metformin escalation (LIME): results from a quasi-experimental study
Hassan S, Sobers N, Paul-Charles J, Herbert J, Dharamraj K, Galusha D, Cruz E, Garcia-Rivera E, Fredericks L, Arniella G, Cattamanchi A, Adams O, Maharaj R, Nazario C, Nunez M, Nunez-Smith M. Diabetes prevention in the Caribbean using lifestyle intervention and Metformin escalation (LIME): results from a quasi-experimental study. BMC Public Health 2025, 25: 4409. PMID: 41275221, PMCID: PMC12754857, DOI: 10.1186/s12889-025-25291-7.Peer-Reviewed Original ResearchPre-diabetesLifestyle interventionQuasi-experimental pre-post studyDiabetes prevention interventionsPhysical activity levelsDiabetes Prevention ProgramPrimary outcomePre-post studyBurden of diabetesQuasi-experimental studyRisk of diabetesDiabetes-associated mortalityVegetable intakeImplementation outcomesPaired t-testTrained facilitatorsDiabetes preventionEligible participantsImplementation fidelityPreventive interventionsProgrammatic dataPrevention programsSugar intakeActivity levelsClinical sitesInterarm blood pressure difference and risk assessment: The ECHORN cohort study
Adams O, Galusha D, Martinez-Brockman J, Morris E, Maharaj R, Nazario C, Nunez M, Nunez-Smith M. Interarm blood pressure difference and risk assessment: The ECHORN cohort study. BJGP Open 2025, 9: bjgpo.2024.0246. PMID: 41402132, PMCID: PMC12820492, DOI: 10.3399/bjgpo.2024.0246.Peer-Reviewed Original ResearchBody mass indexCross-sectional sampleBlood pressureAssociated with systolicMeasured blood pressureArm BPASCVD riskMass indexAssociated FactorsContinuous outcomesRisk thresholdASCVDLow BPLinear regressionRiskRisk classificationDiastolic thresholdDiastolic pressureArmMmHgSystolicParticipantsGuidelinesOutcomesSociodemographic correlates of hypertension prevalence, awareness, and control in the Eastern Caribbean
Oladele C, Miller M, Adams O, Maharaj R, Nazario C, Nunez M, Nunez-Smith M, Desai M. Sociodemographic correlates of hypertension prevalence, awareness, and control in the Eastern Caribbean. The Lancet Regional Health - Americas 2025, 43: 101012. PMID: 40093852, PMCID: PMC11910123, DOI: 10.1016/j.lana.2025.101012.Peer-Reviewed Original ResearchPrevalence of hypertensionMinority HealthSociodemographic correlatesHypertension prevalenceSelf-administered health surveyHypertension care cascadeLow physical activityCommunity-dwelling personsEducational attainmentSelf-reported hypertensionJoint National Committee on PreventionSource of healthcareHigher prevalence of hypertensionAssociated with awarenessLower educational attainmentPredictors of hypertensionAge of participantsControl of hypertensionTreatment of High Blood PressureNational InstitutePhysical activityHealth disparitiesHigh blood pressureCare cascadeHealth SurveyAssessing cardiovascular disease risk and social determinants of health: A comparative analysis of five risk estimation instruments using data from the Eastern Caribbean Health Outcomes Research Network
Schwartz J, Howitt C, Raman S, Nair S, Hassan S, Oladele C, Hambleton I, Sarpong D, Adams O, Maharaj R, Nazario C, Nunez M, Nunez-Smith M. Assessing cardiovascular disease risk and social determinants of health: A comparative analysis of five risk estimation instruments using data from the Eastern Caribbean Health Outcomes Research Network. PLOS ONE 2025, 20: e0316577. PMID: 39854547, PMCID: PMC11760610, DOI: 10.1371/journal.pone.0316577.Peer-Reviewed Original ResearchConceptsCardiovascular disease riskSocial determinants of healthDeterminants of healthSocial determinantsRisk estimation toolsCardiovascular diseaseEstimate 10-year CVD riskCVD riskEastern Caribbean Health Outcomes Research NetworkCardiovascular disease risk estimatesHigh riskHigher level of educationHistory of cardiovascular diseaseHigher CVD riskMultivariate logistic regression modelEthnically diverse populationsResource-constrained settingsLogistic regression modelsNon-professional occupationsSDoH variablesLevel of educationSDOHPerceived social statusRisk toolFramingham
2024
Peripheral Arterial Disease prevalence and risk factors in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort
Adams O, Galusha D, Martinez-Brockman J, Morris E, Hassan S, Maharaj R, Nazario C, Nunez M, Nunez-Smith M. Peripheral Arterial Disease prevalence and risk factors in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort. PLOS ONE 2024, 19: e0306918. PMID: 39186495, PMCID: PMC11346651, DOI: 10.1371/journal.pone.0306918.Peer-Reviewed Original ResearchConceptsEastern Caribbean Health Outcomes Research NetworkAnkle brachial indexPeripheral arterial disease prevalencePeripheral arterial diseasePotential risk factorsSample of community-dwelling peopleRisk factorsCommunity-dwelling peopleAssociation of potential risk factorsFemale sexLower educational attainmentHistory of heart diseaseRisk factors of peripheral arterial diseaseCohort Study participantsAssociated with peripheral arterial diseaseHigh school educationHeart diseaseBody mass indexMultivariate logistic regressionOscillometric deviceAssociation of increasing ageSmoking statusYears of ageStudy participantsHeart disease historyPossible Mediation of the Association Between Education Attainment and Breast Cancer in a Hispanic Female Population Experiencing Historical Changes in Social Determinants of Health
Rosario-Rosado R, Nazario C, Mansilla-Rivera I, Ramírez F, da Luz-Sant'Ana I, Nie J, Hernández-Santiago J, Freudenheim J. Possible Mediation of the Association Between Education Attainment and Breast Cancer in a Hispanic Female Population Experiencing Historical Changes in Social Determinants of Health. JCO Global Oncology 2024, 10: 147-148. DOI: 10.1200/go-24-11700.Peer-Reviewed Original ResearchBreast cancer riskSocial determinants of healthHigher education levelDeterminants of healthSocial determinantsEducational attainmentFamily history of breast cancerPopulation-based case-control studyEducation levelIncreased breast cancer riskHistory of breast cancerUnconditional logistic regression modelsBetter health statusRisk factorsCaribbean Hispanic womenBreast cancerBenign breast diseaseLogistic regression modelsCase-control studyCancer riskHispanic womenHealth statusFamily historyMenopausal statusBreast diseasePrevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study
Ransome Y, Martinez-Brockman J, Galusha D, Thompson T, Adams O, Nazario C, Nunez M, Nunez-Smith M, Maharaj R. Prevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study. Addictive Behaviors 2024, 153: 108001. PMID: 38447411, DOI: 10.1016/j.addbeh.2024.108001.Peer-Reviewed Original ResearchConceptsEastern Caribbean Health Outcomes Research NetworkCorrelates of alcohol useCohort studyAlcohol useAlcohol problemsBinge drinking daysResearch NetworkDrinking daysLogistic regression analysisDrinking statusDescriptive statisticsCollege educationReligious attendanceCaribbean peopleSample characteristicsAlcohol measuresLongitudinal studySchool educationReligious servicesRegression analysisDrinking problemsOddsAlcohol dependenceCohortPrevalence
2023
The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study: Design, Methods, and Baseline Characteristics
Thompson T, Desai M, Martinez-Brockman J, Tessier-Sherman B, Nunez M, Adams O, Nazario C, Maharaj R, Nunez-Smith M. The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study: Design, Methods, and Baseline Characteristics. International Journal Of Environmental Research And Public Health 2023, 21: 17. PMID: 38276805, PMCID: PMC10815461, DOI: 10.3390/ijerph21010017.Peer-Reviewed Original Research
2019
Red Blood Cell Alloimmunization in Pediatric Sickle Cell Disease Population of Puerto Rico: An Observational Study
Balbuena-Merle RI, Nazario-Delgado CM, Rosario-Rosado RV, Millán-Tapia D, Climent-Peris C. Red Blood Cell Alloimmunization in Pediatric Sickle Cell Disease Population of Puerto Rico: An Observational Study. Annals Of Laboratory Medicine 2019, 40: 187-189. PMID: 31650739, PMCID: PMC6822008, DOI: 10.3343/alm.2020.40.2.187.Peer-Reviewed Original Research
2010
Incidence trends of cervical cancer in Puerto Rico, 1987-2004.
Pérez-Irizarry J, Nazario-Delgado C, De la Torre T, Ortiz-Ortiz K, Torres-Cintrón M, Figueroa-Vallés N. Incidence trends of cervical cancer in Puerto Rico, 1987-2004. Puerto Rico Health Sciences Journal 2010, 29: 364-71. PMID: 21261175.Peer-Reviewed Original ResearchConceptsCentral Cancer RegistryIncidence trendsIncidence rateCancer RegistryCervical cancer casesPuerto Rico Central Cancer RegistryCancer casesSquamous cell carcinomaIncidence rate of squamous cell carcinomaIncidence rate of adenocarcinomaPrevalence of risk factorsAnnual percent changeCervical cancerIncidence of cervical cancerHistological typeRate of squamous cell carcinomaRate of adenocarcinomaTop cancersInvasive cervical cancer casesScreening programAge-adjustedRegional hospitalPercent changeInvasive cervical cancerRisk factors