Impact of minority stress on cardiovascular disease risk and resilience

少数群体压力对心血管疾病风险和恢复力的影响

基本信息

批准号：
10372032
负责人：
WALTER O. BOCKTING
金额：
$ 69.53万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
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：
2021-03-15 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10372032
关键词：
Adolescence Affect Age Behavioral Behavioral Risk Factor Surveillance System Biological Markers Blood Pressure Body mass index Buffers Cardiovascular Diseases Cities Cohort Studies Communities Coronary heart disease Data Development Discrimination Ecological momentary assessment Elderly Enrollment Feminization Fostering Funding Future Gender Gender Identity Goals Gold Health Health Promotion Health Services Accessibility Health behavior Home Hormones Individual Intervention Interview Knowledge Longevity Masculine Measurement Measures Medical Mental Depression Mental Health Modeling Morbidity - disease rate Myocardial Infarction National Heart, Lung, and Blood Institute New York City Operative Surgical Procedures Outcome Patient Self-Report Personal Satisfaction Persons Physical activity Population Prejudice Reduce health disparities Reporting Research Research Personnel Risk Risk Factors Sampling San Francisco Sex Characteristics Sexual Health Sleep Social support Stroke Structure Testing Tobacco use Variant Vulnerable Populations Well in self Work actigraphy adequate sleep base cardiovascular disorder risk cisgender cohort coping design disease disparity ethnic minority experience follow-up gender expression gender minority gender minority group gender minority stress health care availability health disparity populations interest longitudinal design minority stress mortality physical conditioning physical inactivity prevent prospective psychologic psychological distress racial and ethnic recruit resilience stress resilience theories transfeminine transgender transmasculine

项目摘要

7. PROJECT SUMMARY/ABSTRACT This project is responsive to NOT-MD-19-001 Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations. Gender minority populations are at increased risk for cardiovascular disease (CVD) morbidity and mortality. Specifically, Behavioral Risk Factor Surveillance System data suggest that, compared to cisgender people, gender minorities are at more than double the risk for myocardial infarction and report greater depression, physical inactivity, and elevated body mass index (BMI), as well as poorer access to healthcare, all of which increase CVD risk. Further, many gender minority individuals take hormones, which may further increase their risk of CVD. According to minority stress theory, the negative impact of prejudice and discrimination is one contributor to CVD risk disparities. Although previous studies have found associations between gender minority stress and poorer self-reported mental health, the impact of minority stress on physical health outcomes, including CVD risk, has not been examined in gender minority populations. The goal of this study is to advance our understanding of how minority stress and resilience affect CVD risk. In an established longitudinal, multisite cohort of gender minority individuals in three U.S. cities (N=390), we aim to: (1) determine the association of minority stress with mental health and CVD risk; (2) determine the impact of social support, access to care, and identity development on mental health and CVD risk; and (3) identify modifiable resilience factors that may influence the relationship of minority stress to mental health and CVD risk in this health disparity population. In addition to structured interviews and Ecological Momentary Assessments (EMA) of stress and resilience at baseline and 2-year follow-up, we will collect 2-week bursts of objective measurements of blood pressure, sleep and physical activity. The proposed research will provide the best evidence to date to guide researchers and clinicians working to develop interventions to reduce CVD disparities in gender minority populations, and promote their long-term health and wellbeing.

7. 项目概要/摘要该项目响应 NOT-MD-19-001 对性和健康研究特别感兴趣的通知性别少数群体 (SGM)。性别少数人群患心血管疾病的风险增加疾病（CVD）发病率和死亡率。具体而言，行为风险因素监测系统数据表明与顺性别者相比，性别少数群体患心肌梗塞的风险是其两倍多并报告更严重的抑郁症、缺乏身体活动、体重指数 (BMI) 升高以及更差的获取途径医疗保健，所有这些都会增加 CVD 风险。此外，许多性别少数群体服用激素，这可能会进一步增加他们患心血管疾病的风险。根据少数压力理论，偏见和偏见的负面影响歧视是造成 CVD 风险差异的因素之一。尽管之前的研究已经发现了关联在性别少数压力与较差的自我报告心理健康之间，少数压力对身体的影响尚未对性别少数群体的健康结果（包括心血管疾病风险）进行检查。此举的目标研究的目的是加深我们对少数族裔压力和适应力如何影响心血管疾病风险的理解。在既定的对美国三个城市的性别少数群体进行纵向、多地点队列研究 (N=390)，我们的目标是：(1) 确定少数群体压力与心理健康和心血管疾病风险之间的关系； (2)确定社会影响支持、获得护理以及对心理健康和心血管疾病风险的认同发展； (3) 识别可修改的可能影响少数群体压力与心理健康和心血管疾病风险之间关系的复原力因素人口健康差距。除了结构化访谈和生态瞬时评估 (EMA) 为了了解基线和 2 年随访时的压力和复原力，我们将收集 2 周的客观测量数据血压、睡眠和体力活动。拟议的研究将提供迄今为止最好的证据指导研究人员和临床医生制定干预措施，以减少少数性别群体的 CVD 差异人口，并促进他们的长期健康和福祉。