Positive Social Determinants of Health and Blood Pressure among Young Black Women with a History of Early Life Stress

有早年压力史的年轻黑人女性健康和血压的积极社会决定因素

基本信息

批准号：
9755772
负责人：
Jewel L. Scott
金额：
$ 3.66万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-01 至 2020-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9755772
关键词：
Adolescence Adolescent Adolescent and Young Adult Adult Age Antihypertensive Agents Area Awareness Behavioral Biological Blood Blood Pressure Buffers Cardiac health Cardiovascular Diseases Child Abuse and Neglect Clinical Color Communities Congestive Heart Failure Correlation Studies Correlative Study Data Data Analyses Data Set Databases Development Diastolic blood pressure Diet Enrollment Environment Ethnic group Exposure to Family Fellowship Female Foundations Functional disorder Funding Future General Population Goals Health Health Promotion Health Services Accessibility Health behavior Heart Diseases High Prevalence Household Hypertension Individual Intervention Knowledge Learning Life Literature Longitudinal Studies Medical Mentors Outcome Pharmaceutical Preparations Physical activity Population Populations at Risk Prevalence Primary Health Care Race Recording of previous events Reporting Research Research Training Risk Risk Behaviors Risk Factors Role Sampling Scientist Severities Socioeconomic Status Spirituality Stress Stroke Time Tobacco use Training United States United States National Institutes of Health Woman Women&apos s Health Work adverse childhood events base cardiovascular disorder risk cardiovascular risk factor cohort depressive symptoms design disorder prevention early experience early life stress experience follow-up gene environment interaction health disparity health equity heart disease risk hypertension prevention improved innovation mortality normotensive novel novel strategies peer population health prevent public health relevance social social health determinants young adult

项目摘要

ABSTRACT Black women have among the highest prevalence of hypertension of all other racial and ethnic groups in the world, and hypertension is a primary risk factor for other forms of cardiovascular disease (CVD) such as stroke. Twenty years of health disparities research has largely focused on studying the health behaviors of Black women with hypertension with little improvement in either their blood pressure or their overall CV health. An emerging area of CVD research shows that early life stress, like severe household dysfunction and child maltreatment, independently doubles the odds of CVD even after controlling for traditional risk behaviors. Yet, few studies have investigated the potential association of early life stress and hypertension in Black females. Even fewer studies have used a strengths-based approach to understand Black females who experience early life stress but maintain a healthy blood pressure. Individual, family and community supports are positive social determinants of health that may work together to buffer the negative effects of early life stress on blood pressure in Black females, but we know little about these relationships. To fill this gap, the overall goal of this descriptive, correlational study is to examine the influence of early life stress, defined as exposure to adverse childhood events (ACEs), on hypertension and determine the extent to which positive social determinants of health counter the effects of ACEs using data from 14 years of follow-up in 900 young Black women, ages 24- 32, who participated in the National Longitudinal Study of Adolescent to Adult Health. The specific aims of this study are to (1) determine the relationship between cumulative positive social determinants of health at the individual (spirituality), family (parental relationships), and community (social connections) levels and severity of early life stress (ACEs) on both blood pressure and the absence of hypertension among Black females who experienced ACEs; and (2) explore the individual contribution of each positive social determinant of health and severity of early life stress (ACEs) on blood pressure and the absence of hypertension among Black females with a history of ACEs. This study may help to shift the paradigm of health disparities research to focus on leveraging strengths that may inform future tailored, culturally sensitive interventions to improve the CV health of Black women. In addition to supporting completion of the proposed study, this fellowship will support the development of an independent scientist by providing extensive 1:1 mentoring and training in health equity research, secondary data analysis of large datasets, and dissemination of scientific knowledge. These goals will be achieved in a strong research environment with a long history of NIH funding. Building on a strong clinical foundation in community- based primary care, this fellowship will provide the applicant with research training to prepare for a postdoctoral fellowship that builds on the proposed study to examine gene-environment interactions and CVD in populations of color. The fellowship and training goals will cultivate the applicant’s expertise in CVD, the biological effects of stress on women’s health, and the use of large databases to answer rigorous research questions.

抽象的黑人妇女在所有其他种族和族裔中的高血压率最高世界和高血压是其他形式的心血管疾病（CVD）（例如中风）的主要危险因素。二十年的健康差异研究主要集中于研究黑人的健康行为高血压的妇女的血压或整体简历健康状况几乎没有改善。一个 CVD研究的新兴领域表明，早期生活压力，例如严重的家庭功能障碍和儿童虐待，即使控制传统的风险行为，也可以独立地加倍CVD。然而，很少有研究研究黑人女性早期生活压力和高血压的潜在关联。甚至更少的研究使用了基于优势的方法来了解早期体验的黑人女性生命压力，但保持健康的血压。个人，家庭和社区支持是积极的社会健康的决定因素可能会共同缓解早期压力对血液的负面影响黑人女性的压力，但我们对这些关系一无所知。为了填补这一空白，总体目标描述性的相关研究是检查早期生活压力的影响，定义为暴露于逆境儿童事件（ACE），高血压并确定积极的社会决定者的程度健康对抗ACE的影响使用来自900名年轻黑人妇女的14年随访的数据，年龄在24岁之间 32岁，参加了针对成人健康青少年的国家纵向研究。这个特定的目的研究是（1）确定累积积极社会决定者健康的关系个人（灵性），家庭（父母关系）和社区（社会联系）的水平和严重性黑人女性的血压和缺乏高血压的早期生活压力（ACE）经验丰富的A; （2）探索每个积极的健康社会决定者的个人贡献，早期生活压力的严重程度（ACE）对血压和黑人女性缺乏高血压的严重程度 ac史的历史。这项研究可能有助于改变健康差异研究的范式，以专注于利用可能会为未来量身定制的文化敏感干预措施的优势提高黑人妇女的简历健康。除了支持完成拟议的研究的完成外，该奖学金还将支持开发独立科学家通过提供广泛的1：1卫生公平研究的心理和培训，二级数据大型数据集的分析和科学知识的传播。这些目标将在一个强大的 NIH资金历史悠久的研究环境。建立在社区中强大的临床基础的基础上 - 基于初级保健，该奖学金将为申请人提供研究培训，为博士后做准备基于拟议的研究基于研究基因环境相互作用和人群中CVD的研究金颜色。奖学金和培训目标将培养申请人在CVD中的专业知识，即生物学效果对妇女健康的压力以及使用大型数据库来回答严格的研究问题。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Equity in Genomics: A Brief Report on Cardiovascular Health Disparities in African American Adults.

DOI：
10.1097/jcn.0000000000000725
发表时间：
2022-01-01
期刊：
The Journal of cardiovascular nursing
影响因子：
0
作者：
Scott J;Cousin L;Woo J;Gonzalez-Guarda R;Simmons LA
通讯作者：
Simmons LA

Adverse Childhood Experiences and Cardiovascular Health: An Exploration of Protective Social Determinants Among Young Adult Black Women.

不良童年经历与心血管健康：年轻成年黑人女性保护性社会决定因素的探索。

DOI：
10.1097/ans.0000000000000468
发表时间：
2022
期刊：
ANS. Advances in nursing science
影响因子：
0
作者：
Scott,Jewel;Silva,Susan;Gonzalez-Guarda,RosaM;Bennett,GaryG;Merwin,Elizabeth;Simmons,LeighAnn
通讯作者：
Simmons,LeighAnn

Learner Response to an Activity Introducing Adverse Childhood Experiences as a Social Determinant of Health.

学习者对介绍不良童年经历作为健康社会决定因素的活动的反应。