Social and Cultural Influences on Cardiovascular Risk in South Asians

社会和文化对南亚人心血管风险的影响

• 批准号: 8605408
• 负责人: NAMRATHA R KANDULA
• 金额: $ 70.2万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8605408
• 关键词: Address; American; Americas; Asians; Atherosclerosis; Automobile Driving; Behavior; Behavior Therapy; Belief; Body mass index; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chinese People; Cohort Studies; Communities; Coronary heart disease; Data; Development; Diabetes Mellitus; Diet; Epidemiology; Ethnic group; Etiology; Family; Feeling; Food; Future; Generations; Goals; Health; Health Personnel; Health behavior; Heterogeneity; High Prevalence; Hispanics; Immigrant; India; Individual; Interdisciplinary Study; Intervention; Interview; Investments; Life; Link; Maintenance; Mediating; Mediator of activation protein; Methods; Minority; National Heart, Lung, and Blood Institute; Non-Insulin-Dependent Diabetes Mellitus; Overweight; Pakistan; Participant; Pathway Analysis; Personal Satisfaction; Physical activity; Population; Prevention; Prevention Research; Preventive Intervention; Provider; Qualitative Methods; Research; Research Methodology; Risk; Risk Factors; Social Controls; Social Environment; Social Network; South Asian; Structure; Testing; Time; United States; United States National Institutes of Health; Weight Gain; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular risk factor; cohort; density; health belief; improved; insight; meetings; member; mortality; network models; nutritional epidemiology; population based; preference; prevent; prospective; public health relevance; racial and ethnic; social; success; waist circumference

Project Summary: Individual-level interventions to prevent cardiovascular disease (CVD) have been met with limited success in many minority communities, partly because they do not address the sociocultural context in which individuals live and make food and physical activity choices. Widening our inquiry beyond the individual, to the larger social drivers can provide key insights into how social influences can be leveraged in interpersonal and community-level interventions to engage at-risk communities. Social networks influence health via many mechanisms: social influence and control; establishment of health beliefs and normative behaviors; feelings of shared identity and belonging; and provision of support. Social influences are key determinants of health; yet social network analysis has rarely been used to examine links between social networks and health in minorities. The Mediators of Atherosclerosis in South Asians Living in American (MASALA) study is the first population-based cohort of South Asians (SAs) in the United States and is a substantial investment by the National Institutes of Health to understand the CVD disparities in the rapidly growing SA population. We propose to leverage that investment to investigate social network structures and sociocultural drivers of CVD risk factors in the MASALA cohort. Social relationships an especially important influence on SAs health behaviors because 90% are immigrants who believe kinship and family are paramount with emphasis on collectivism, social control, and maintenance of group identity. Our data from the MASALA study show that SAs have the highest prevalence of diabetes, an important CVD risk factor, and the lowest levels of physical activity compared to Whites, Blacks, Hispanics, and Chinese in the Multiethnic Study of Atherosclerosis. We also find that sociocultural influences may be partly driving these disparities and that individual-level prevention efforts may not be as effective in the tightly-knit, family-oriented SA community. In the proposed ancillary project, the multidisciplinary research team will utilize quantitative social network methods to: 1) Uncover the unmeasured sociocultural drivers of variance in proximal CVD risk factors (body mass index, waist circumference, diet and physical activity behaviors); and qualitative methods to: 2) Investigate the meaning, significance, and function of SAs' social networks with respect to how they influence food and physical activity preferences and constraints. Qualitative interviews will provide greater context to the quantitative findings and elucidate mutable avenues for future intervention. Our team, with expertise in CVD prevention and nutritional epidemiology, sociocultural determinants of health, and social network analysis is well-poised to conduct this mixed methods research. The proposed research addresses critical gaps in CVD prevention research: understanding the influence of social networks on CVD risk and how these influences can be leveraged to improve the cardiovascular health of immigrant and minority communities.

项目摘要：已经遇到了预防心血管疾病（CVD）的个人水平干预措施 在许多少数民族社区中的成功有限，部分是因为它们没有解决社会文化背景 个人生活并做出食物和体育锻炼的选择。扩大我们的询问超出个人， 对于更大的社会驱动力，可以提供有关如何在人际关系中利用社会影响的关键见解 以及社区级干预措施，以吸引处于危险的社区。社交网络通过许多人影响健康 机制：社会影响力和控制；建立健康信念和规范行为；感受 共同的身份和归属；和提供支持。社会影响是健康的关键决定因素；然而 社交网络分析很少用于检查社交网络与健康之间的联系 少数民族。 居住在美国人（Masala）研究的南亚动脉粥样硬化的介体是第一个 在美国，基于人群的南亚人队（SAS）是一项大量投资 国立卫生研究院了解迅速增长的SA人口中的CVD差异。我们 建议利用这项投资调查CVD的社交网络结构和社会文化驱动因素 Masala队列中的风险因素。社会关系对SAS健康特别重要 行为是因为有90％的移民相信亲属关系和家庭至关重要 集体主义，社会控制和群体身份的维护。我们来自Masala研究的数据表明 SA的患病率最高，重要的CVD风险因素和最低水平的物理 在动脉粥样硬化的多种族研究中，与白人，黑人，西班牙裔和中国人相比，活动的活动。我们 还发现社会文化的影响可能部分驱动这些差异，并且个人级别的预防 在紧密联系的，面向家庭的SA社区中，努力可能不会有效。 在拟议的辅助项目中，多学科研究团队将利用定量社会 网络方法：1）揭示近端CVD风险因素中未满足的社会文化驱动因素 （体重指数，腰围，饮食和体育锻炼行为）；和定性方法：2） 研究SAS社交网络对它们的影响的含义，意义和功能 食品和体育锻炼的偏好和约束。定性访谈将为您提供更大的背景 定量发现并阐明可突变的途径，以进行将来的干预。我们的团队，具有CVD的专业知识 预防和营养流行病学，健康的社会文化决定因素和社交网络分析是 精力进行这种混合方法研究。拟议的研究解决了CVD中的关键差距 预防研究：了解社交网络对CVD风险的影响以及这些影响如何 杠杆化以改善移民和少数民族社区的心血管健康。