Stress and Type 2 Diabetes among Indigenous Adults

原住民成年人的压力和 2 型糖尿病

• 批准号: 8437010
• 负责人: Melissa L. Walls
• 金额: $ 52.73万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-10 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8437010
• 关键词: Adult; Affect; Alcohol or Other Drugs use; American Indian and Alaska Native; American Indians; Amputation; Anishinabe; Anxiety; Anxiety Disorders; Biological Markers; Blood Pressure; Cardiovascular Diseases; Clinic; Clinical assessments; Collaborations; Communities; Data; Depressed mood; Development; Diagnosis; Diagnostic; Disadvantaged; Discrimination; Disease; Disease Progression; Distress; Economics; Emotional; Epidemic; Evaluation; Exercise; Fatigue; Feedback; General Population; Glucose; Goals; High Prevalence; Hydrocortisone; Hyperglycemia; Hypoglycemia; Indian reservation; Indigenous; Interview; Language; Link; Lipids; Long-Term Effects; Low Prevalence; Measurement; Measures; Mental Depression; Mental Health; Mental disorders; Minnesota; Modeling; Motivation; NIH Program Announcements; National Institute of Diabetes and Digestive and Kidney Diseases; Newly Diagnosed; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Ojibwe; Onset of illness; Participant; Patient Self-Report; Physiological; Population; Process; Property; Psychometrics; Psychosocial Stress; Recording of previous events; Research; Reservations; Resolution; Retinal Diseases; Risk Factors; Rural; Salivary; Self Care; Severity of illness; Staging; Stress; Surveys; Symptoms; Time; Trauma; Unemployment; Violence; Wisconsin; Work; base; biological adaptation to stress; cohort; community based participatory research; compliance behavior; coping; depressive symptoms; dietary restriction; emotional distress; experience; glycemic control; health disparity; innovation; interest; prevent; psychosocial; response; single episode major depressive disorder; stressor

DESCRIPTION (provided by applicant): This revised RO1 application is in response to the Health Disparities in NIDDK Diseases Program Announcement (PA-09-262). It focuses on American Indians (AI) whose rates of type 2 diabetes (T2D) are the highest in the world. This population also copes with disproportionate stressors including economic disadvantage, unemployment, community violence, discrimination, and the long- term effects of historical cultural traumas and losses. Yet, paradoxically, AI people tend to score lower on some self-report measures of stress and have lower prevalence rates of stress-related mental disorders such as major depressive episode and anxiety disorders. The goals of the proposed research are to advance measurement of stress processes among AI people through comparisons of stress biomarkers and self-report measures; and to use multiple indicators of stress including stress biomarkers to investigate the interactions between stress processes T2D disease progression and treatment compliance among AI adults. This community based participatory research is based on partnerships with five Ojibwe reservations in Minnesota and Wisconsin who invited the research team to work with their clinics. The first specific aim is to couple our existing preliminary data on community salient stressors with new qualitative feedback on existing measures to adapt and subsequently examine via pilot surveys the psychometric properties of stress measures for this population. The second specific aim is to investigate the relationship between stress biomarkers and self-reported psychosocial stressors, symptoms of distress, and diagnostic measures of anxiety, depression, and trauma to ascertain the degree to which self report measures are indicative of actual physiological stress levels among a cohort of 200 AI adults who have been recently diagnosed with T2D. The third specific aim is to follow a cohort of 200 recently diagnosed T2D AI adults for two years to investigate an innovative conceptual model (Figure 1) of multiple measures of stress processes, treatment compliance, mental health, and risk factors for disease complications PUBLIC HEALTH RELEVANCE: This health disparities research will advance our understanding of stress processes and type 2 diabetes (T2D) among American Indian (AI) people by refining measures of stress among this population through use of stress biomarkers and cultural adaptation/development of self-report stress measures. It will then prospectively investigate the effects of stress on T2D disease progression by following a cohort of 200 newly diagnosed AI adults for a period of two years.

描述（由申请人提供）：此修订后的RO1申请响应NIDDK疾病计划公告的健康差异（PA-09-262）。它着重于美国印第安人（AI），其2型糖尿病（T2D）的发生率是世界上最高的。该人群还应对不成比例的压力源，包括经济劣势，失业，社区暴力，歧视以及历史文化创伤和损失的长期影响。然而，自相矛盾的是，AI人在某些自我报告的压力度量上倾向于较低，并且与压力有关的精神障碍（例如重大抑郁发作和焦虑症）的患病率较低。拟议的研究的目标是通过比较压力生物标志物和自我报告措施来提高AI人之间的压力过程；并使用包括应力生物标志物在内的多种压力指标来研究应力过程之间的相互作用T2D疾病进展与AI成年人之间的治疗依从性。这项基于社区的参与性研究基于与明尼苏达州和威斯康星州的五个Ojibwe保留的合作伙伴关系，他们邀请研究团队与诊所合作。第一个具体目的是将我们现有的有关社区显着压力源的初步数据与现有措施的新定性反馈，以适应和随后通过飞行员调查该人群的压力度量的心理测量特性。第二个具体目的是研究压力生物标志物与自我报告的社会心理压力源，困扰症状以及焦虑，抑郁和创伤的诊断度量，以确定自我报告措施表明最近有200个AI成年人的实际生理压力水平的程度，他们最近被诊断为T2D。第三个具体目的是遵循200个最近诊断为T2D AI成年人两年的队列，以研究一种创新的概念模型（图1），多种措施压力过程，治疗依从性，心理健康和疾病并发症的风险因素 公共卫生相关性：这种健康差异研究将通过使用压力生物标志物和文化适应/自我报告压力措施的文化适应/发展，通过完善该人群中的压力度量来提高我们对压力过程和2型糖尿病（T2D）的理解。然后，它将通过遵循200个新诊断为AI成年人的队列长达两年的队列，前瞻性地研究压力对T2D疾病进展的影响。