Understanding Diverging Profiles of Academic and Physical Health Outcomes in African American Youth

了解非裔美国青年学业和身体健康状况的差异

基本信息

批准号：
10153460
负责人：
EDITH CHEN
金额：
$ 83.17万
依托单位：
NORTHWESTERN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-24 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10153460
关键词：
Address Adult African American Age Aging American Americas Behavior Behavioral Biological Biological Markers Cardiovascular Diseases Childhood Chronic Chronic Disease Chronology Clinical Costs and Benefits DNA Methylation Data Data Set Development Discrimination Disease Economics Endothelium Environment Epigenetic Process European Exhibits Family Family Relationship Foundations Goals Health Health behavior Hormonal Hormones Immune Imprisonment Income Individual Inflammatory Intervention Label Leukocytes Life Literature Longitudinal Studies Low income Maps Measures Mediating Mental Health Metabolic syndrome Minority Modeling Neighborhoods Non-Insulin-Dependent Diabetes Mellitus Outcome Output Pathway interactions Pattern Persons Physiological Problem behavior Process Psyche structure Race Research Risk School Drop-Outs Schools Self-control as a personality trait Skin Social Network Stress Subgroup Surface Testing Time Ursidae Family Vasodilation Work Youth allostatic load burden of illness cardiometabolism cardiovascular risk factor cohort college cost diabetes risk disorder risk economic disparity endothelial dysfunction expectation experience health disparity help-seeking behavior high risk high school interest longitudinal design low socioeconomic status lower income families peer physical conditioning prevent preventive intervention primary outcome psychologic psychosocial public health relevance racial disparity recruit resilience risk stratification secondary outcome skin organogenesis stressor success

项目摘要

PROJECT SUMMARY Across the lifecourse, there are pronounced racial and economic disparities in important life outcomes in America, ranging from educational attainment to incarceration rates to physical health. Nonetheless, a substantial minority of African American youth who grow up under economic hardship achieves positive outcomes, a phenomenon termed resilience. Our research has recently revealed a paradox in the resilience literature. This literature often assumes that if at-risk youth manage to thrive in terms of observable behaviors, such as making it to college, then they have avoided the consequences of adversity. In contrast, we have identified a subgroup of youth who appear resilient on the surface via academic and behavioral indicators, but `under the skin' display signs of compromised physical health, such as higher risk of diabetes and higher scores on allostatic load (a multi-system indicator of chronic disease risk). These findings suggest that the same factors that help youth to succeed academically and psychosocially may be exacting a toll on them physically, resulting in resilience that is only `skin-deep.' Here we propose a project that will clarify why skin- deep resilience develops, when in development it emerges, and whether early-warning signs can be detected. We will recruit 450 African American youth from low-income families ages 14-19. They will be assessed at baseline and 1 and 2 years later, in the context of an accelerated longitudinal design (ALD). The first aim is to identify individual psychological and social network factors that contribute to skin-deep resilience, such as high levels of self-control that may promote academic success but have physiological costs, as well as a lack of belonging or experiences of discrimination with peers in academic environments among skin-deep resilient youth. The second aim is to create biological risk profiles that can function as early warning signs of developing health problems in African American youth. To that end, we will collect in-depth measures of stress hormone output, inflammatory activity, and epigenetic aging over a 2-year period, and test these markers' ability to predict subsequent cardiovascular risk, including metabolic syndrome (primary outcome) and flow- mediated vasodilation (an indicator of endothelial dysfunction; secondary outcome). The third aim is to determine when skin-deep resilience emerges and to characterize its developmental trajectory. To that end, we will use the accelerated longitudinal design to map skin-deep resilience, and its academic, psychosocial, and biological features across the high school and college years. Through this work, we will identify psychosocial targets for intervention, pinpoint optimal development windows for intervention, and highlight biological early warning signs, with the ultimate goal of preventing the emergence of chronic health conditions in low-income minority youth who are otherwise on a track to successful life outcomes.

项目摘要在整个生命过程中，重要的生活结果存在明显的种族和经济差异美国，从受教育程度到监禁率到身体健康。尽管如此，在经济困难下长大的非洲裔美国青年少数人取得了积极的成就结果，这种现象称为弹性。我们的研究最近揭示了弹性的悖论文学。该文献通常假设，如果处于可观察的行为方面，高危青年就可以壮成长，请例如上大学，然后他们避免了逆境的后果。相比之下，我们有确定了一个通过学术和行为指标在表面上看起来有韧性的青年亚组，但是 “在皮肤下”显示出身体健康损害的迹象，例如糖尿病风险较高和更高的风险同层负荷的评分（慢性疾病风险的多系统指标）。这些发现表明帮助青年在学术和心理上取得成功的相同因素可能会对他们造成严重损失从身体上讲，导致弹性仅是“皮肤深处”。在这里，我们提出了一个项目，该项目将阐明为什么皮肤 - 深度的弹性会发展，在发展中出现时，以及早期训练的迹象是否可以检测到。我们将招募来自14-19岁低收入家庭的450名非裔美国青年。他们会的在加速纵向设计（ALD）的背景下，在基线和1和2年后进行评估。这第一个目的是确定有助于皮肤韧性的个人心理和社交网络因素，例如高水平的自我控制，可能会促进学术成功但具有生理成本，以及在皮肤深处，在学术环境中缺乏与同龄人歧视的归属感或经历韧性的青年。第二个目的是创建可以作为预警信号发挥作用的生物风险概况在非洲裔美国青年中发展健康问题。为此，我们将收集深入的压力衡量激素输出，炎症活性和表观遗传衰老在2年内，并测试这些标记物能够预测随后的心血管风险，包括代谢综合征（主要结果）和流动介导的血管舒张（内皮功能障碍的指标；次要结果）。第三个目标是确定何时出现皮肤深处的弹性并表征其发育轨迹。为此，我们将使用加速的纵向设计来绘制皮肤深度的韧性及其学术，心理社会和高中和大学期间的生物学特征。通过这项工作，我们将确定社会心理干预的目标，确定干预的最佳开发窗口，并提早突出生物学警告信号，最终目的是防止低收入慢性健康状况的出现少数族裔青年，否则就可以追求成功的生活成果。