Developing Novel Intervention Approaches to Mitigate Cardiovascular Risk among Young African-American Women

开发新的干预方法来降低年轻非洲裔美国女性的心血管风险

基本信息

批准号：
10215733
负责人：
Anika Latrice Hines
金额：
$ 16.41万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10215733
关键词：
Academic Medical Centers Address African American Aftercare Age Award Behavior Behavior Therapy Behavioral Medicine Blood Blood Pressure Cardiovascular Diseases Chronic Chronic Disease Chronic stress Clinical Complex Coupled Data Development Devices Diabetes Mellitus Discrimination Ecological momentary assessment Electrocardiogram Emotions End stage renal failure Endocrine Ensure Environment Ethnic group Evidence based intervention Exposure to Foundations Funding Gender Goals Grant Health Health Policy Health Services Health Services Research Health behavior Hour Hypertension Incidence Individual Inflammatory Response Intervention Intervention Trial Interview K-Series Research Career Programs Life Life Cycle Stages Link Literature Longevity Measures Mentors Methods Monitor Moods Morbidity - disease rate Obesity Outcome Assessment Participant Pathway interactions Physiologic Monitoring Physiological Plant Roots Policies Population Preparation Prevention Primary Prevention Protocols documentation Qualitative Methods Race Randomized Randomized Controlled Trials Reporting Research Research Personnel Research Training Risk Risk Factors Sample Size Secondary Prevention Solid Statistical Data Interpretation Stress Subgroup Surveys Technology Testing Time Training Universities Virginia Vulnerable Populations Woman Work allostatic load arm behavior change behavioral clinical trial behavioral response biological adaptation to stress blood pressure regulation cardiovascular disorder risk cardiovascular risk factor career career development community engagement coping coping mechanism design early onset ethnic minority population evidence base experience feasibility testing health disparity health equity heart rate variability implementation outcomes in vivo innovation laboratory experience male medical schools men mobile application mortality novel pilot trial professor psychologic racial and ethnic racial disparity recruit relating to nervous system response satisfaction sex skills social epidemiology social stress stress management stress reduction stressor therapy development

项目摘要

PROJECT SUMMARY Hypertension contributes to high rates of morbidity and mortality of other chronic conditions, including cardiovascular disease, obesity, diabetes, and end stage renal disease. African Americans (AAs) are more likely to develop high blood pressure and at a younger age compared to other racial/ethnic groups, and despite higher treatment rates, are less likely to have blood pressure under control. Racial disparities persist by sex—AA women have higher incidence of hypertension and earlier onset compared to their white counterparts. Experiences of stress, including race- and gender-related stress, and stress-related coping are thought to be at the root of these disparities. African American women demonstrate greater stress as evidenced by higher allostatic load over the life course relative to male and white counterparts. Higher incidence and earlier onset of hypertension make younger AA women a prime target for prevention; however, the development of effective prevention-focused interventions is inhibited by limited understanding of underlying mechanisms in this subgroup. To fill these critical gaps, this proposal will use a sequential mixed methods approach, including the following: 1) quantifying stress responses in vivo using a 14-day ecological momentary assessment (EMA) protocol with 24-hour physiological monitoring; and 2) developing and testing the feasibility, acceptability and preliminary efficacy of a stress management intervention that may mitigate the effects of the chronic stress on blood pressure levels in young AA women. The candidate for this mentored Career Development Award, Dr. Anika L. Hines, is an Assistant Professor in Health Behavior and Policy at the Virginia Commonwealth University School of Medicine. Her long term career goal is to: 1) become an independent investigator who explicates the complex and cumulative effects of stress in the lived experiences of racial/ethnic minorities within the context of health disparities; and 2) design and implement innovative, evidence-based interventions and policies to address these stressors using an interdisciplinary, socioecological approach. During this award, Dr. Hines will undergo rigorous didactic and research training, including an didactic courses, experiential lab training, and practical research experience, that will substantially build her skills in intervention development and the conduct of randomized controlled trials for behavioral interventions. These career development activities will be conducted within the rich training environment of Virginia's largest academic medical center with direct guidance from mentors, advisors, and collaborators with expertise in multi-level and behavioral interventions, evidence-based behavioral medicine approaches, race-related stress, qualitative methods, physiological pathways linking stress and cardiovascular risks, advanced statistical analyses, health equity, and grant development. These activities will provide Dr. Hines with a solid foundation to ensure her successful transition to an independent, interdisciplinary investigator who is well equipped to conduct behavioral intervention trials in service of health equity.

项目概要高血压导致其他慢性病的高发病率和死亡率，包括心血管疾病、肥胖、糖尿病和终末期非裔美国人 (AA) 的可能性更大。与其他种族/族裔群体相比，患高血压的年龄更小，尽管治疗率方面，血压得到控制的可能性较小，但性别差异仍然存在——AA 女性。与白人同事相比，他们的高血压发病率更高且发病更早。压力，包括与种族和性别相关的压力以及与压力相关的应对方式被认为是这些问题的根源非洲裔美国女性表现出更大的压力，这一点可以通过比男性更高的调节负荷来证明。生命历程相对男性来说，白唇病的发病率较高且发病较早。年轻的 AA 女性是预防的主要目标；然而，开发以预防为主的有效方法；由于对该亚组的潜在机制了解有限，干预措施受到限制。为了弥补差距，本提案将使用顺序混合方法，包括以下内容：1）量化压力使用 14 天生态瞬时评估 (EMA) 方案和 24 小时生理反应进行体内反应监测；2) 制定和测试压力的可行性、可接受性和初步效果管理干预可以减轻慢性压力对年轻人血压水平的影响 AA 女性。该指导职业发展奖的候选人 Anika L. Hines 博士是助理教授她在弗吉尼亚联邦大学医学院获得健康行为与政策博士学位。目标是：1）成为一名独立调查员，解释压力的复杂和累积影响少数族裔/族裔在健康差异背景下的生活经历；2) 设计和实施创新的、基于证据的干预措施和政策，以解决这些压力源在这个奖项期间，海因斯博士将接受严格的教学和社会生态学方法。研究培训，包括教学课程、体验式实验室培训和实践研究经验，将大大提高她在干预措施开发和随机对照试验方面的技能这些职业发展活动将在丰富的培训中进行。弗吉尼亚州最大的学术医疗中心的环境，有导师、顾问和专家的直接指导具有多层次行为干预、循证行为医学专业知识的合作者方法、与种族相关的压力、定性方法、连接压力和心血管的生理途径这些活动将为海因斯博士提供风险、高级统计分析、健康公平和赠款开发等方面的知识。具有坚实的基础，可确保她成功过渡为独立的跨学科调查员完全有能力进行行为干预试验，以服务于健康公平。