An Interpersonal Relationships Intervention for Improving Cardiovascular Health in Youth

改善青少年心血管健康的人际关系干预

基本信息

批准号：
10449171
负责人：
EDITH CHEN
金额：
$ 6.09万
依托单位：
NORTHWESTERN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10449171
关键词：
Adult Affect Age Atherosclerosis Attention Behavioral Biological Blood Glucose Blood Pressure Body mass index Cardiovascular Diseases Cardiovascular system Chicago Child Childhood Cholesterol Chronic Disease Climacteric Cognitive Control Groups Development Disadvantaged Disease Disease Outcome Emotional Ethnic Origin Fostering Foundations Glucose Guidelines Health Health Benefit Health behavior High School Student Individual Inflammation Inflammatory Interpersonal Relations Intervention Intervention Studies Lead Learning Life Life Style Link Lipids Low income Measures Mediating Mediator of activation protein Mentors Minority Minority Groups Modeling National Heart, Lung, and Blood Institute Neurosecretory Systems Obesity Observational Study Outcome Pathway interactions Physiological Population Populations at Risk Prevention approach Primary Prevention Process Psychophysiology Race Randomized Randomized Controlled Trials Research Risk Schools Social support Societies Socioeconomic Status Stress Students System Testing Time Underrepresented Minority United States National Institutes of Health Ursidae Family Work Youth base behavioral response burden of illness cardiovascular health cardiovascular risk factor clinical predictors diet and exercise elementary school evidence based guidelines experience experimental study fasting glucose health disparity improved indexing insulin sensitivity intervention participants low socioeconomic status lower income families minority children mortality novel novel strategies peer physical conditioning post intervention primary outcome programs psychosocial public health relevance response scaffold skills social attachment social relationships socioeconomic disparity stress management stressor student mentoring success university student volunteer

项目摘要

PROJECT SUMMARY Disparities in cardiovascular (CV) diseases by socioeconomic status (SES) and race/ethnicity are pronounced in our society, and the processes that lead to these disparities begin in childhood. Previous intervention efforts have targeted individual lifestyle changes in health behaviors, but with limited success in low SES, minority youth. We propose a novel intervention to reduce CV risk in low SES, minority children (under 21 by NIH guidelines) that focuses on social relationships – specifically mentoring – as a way to create bi-directional benefits for CV health in youth. The rationale for this intervention is based both on work showing that receiving social support has benefits for physical health, and on work demonstrating that helping others is associated with better physical health. In this proposed intervention study, college students will serve as mentors to elementary school students (8th graders). 250 college students and 250 Chicago Public School 8th graders will be randomized to either serve as a mentor/mentee or to be in a control group. Students will participate in a weekly mentoring intervention throughout one school year. Assessments will occur at 3 time points during the school year. All mentors and mentees will come from low-income families and underrepresented minority groups, thus allowing us to focus on improving CV health in an at-risk population that experiences a disproportionate share of the CV burden in the U.S. The first aim of the project is to investigate whether mentors can reduce CV risk (obesity; blood pressure; cholesterol; blood glucose) in low-income, minority youth mentees relative to a control group of 8th graders. The second aim is to investigate whether serving as a mentor can reduce CV risk in the college student mentors compared to a control group of college students. The third aim is to understand how mentoring influences the intervention targets of psychosocial, health behavior, and biological variables, and whether these variables mediate the impact of mentoring on CV health. Drawing from the stress buffering model of social support, we propose that mentoring fosters the development of strong social relationships that can scaffold behavioral changes and hence mitigate the effects that stress has on inflammation and CV health via 2 pathways: psychophysiological and health behaviors. In the psychophysiological pathway, mentoring creates more adaptive cognitive, emotional, and behavioral responses to life stressors, which in turn mitigate responses of the sympathetic and neuroendocrine systems to stress. Over time, this reduces inflammation and improves CV health. In the health behaviors pathway, the scaffolding from mentoring relationships mitigates the associations of stress with detrimental health behaviors that in turn are linked to both inflammation and CV health. Through this study, we take a social relationships- oriented primary prevention approach to reducing health disparities by targeting CV risk factors that emerge early in life and that predict clinical CV disease outcomes into adulthood and by focusing on low-income, minority mentors and mentees who represent an at-risk, underserved, and disadvantaged group of youth.

项目概要不同社会经济地位 (SES) 和种族/民族的心血管 (CV) 疾病差异很明显在我们的社会中，导致这些差异的过程始于童年时期。有针对性地改变个人生活方式以改变健康行为，但在低社会经济地位、少数群体中取得的成功有限我们提出了一种新的干预措施，以降低社会经济地位低的少数民族儿童（NIH 21 岁以下）的心血管风险。指南），重点关注社会关系 - 特别是指导 - 作为创建双向关系的一种方式这种干预措施的基本原理是基于研究表明接受治疗。社会支持对身体健康和工作都有好处，表明帮助他人是相关的在这项拟议的干预研究中，大学生将担任导师。小学生（八年级学生）将包括 250 名大学生和 250 名芝加哥公立学校八年级学生。被随机分配为导师/受训者或对照组。学生将参加一个小组。整个学年中每周的辅导干预将在 3 个时间点进行。学年，所有导师和受训者都将来自低收入家庭和代表性不足的少数族裔。群体，从而使我们能够专注于改善经历过疾病的高危人群的心血管健康在美国，简历负担的比例不成比例。该项目的首要目标是调查是否导师可以降低低收入少数族裔青年的心血管风险（肥胖、血压、胆固醇、血糖）第二个目的是调查是否作为一个八年级学生的对照组。与对照组大学生相比，导师可以降低大学生导师的简历风险。第三个目标是了解指导如何影响心理社会、健康等方面的干预目标。行为和生物变量，以及这些变量是否介导指导对 CV 健康的影响。根据社会支持的压力缓冲模型，我们建议指导促进发展强大的社会关系可以支撑行为改变，从而减轻压力的影响通过两种途径影响炎症和心血管健康：心理生理和健康行为。心理生理途径，指导创造了更具适应性的认知、情感和行为对生活压力的反应，进而减轻交感神经和神经内分泌系统对生活压力的反应随着时间的推移，可以减少这种炎症并改善心血管健康。指导关系的支架减轻了压力与不健康健康行为的关联反过来，这与炎症和心血管健康有关。通过这项研究，我们研究了社会关系—— 通过针对出现的心血管风险因素来减少健康差异的定向初级预防方法生命早期并预测成年后的临床心血管疾病结果，并通过关注低收入、代表高危、服务不足和弱势的青年群体的少数族裔导师和受训者。