Neighborhood Environments and Cardiometabolic Disorders in Hispanic/Latinos

西班牙裔/拉丁裔的社区环境和心脏代谢紊乱

• 批准号: 8945851
• 负责人: Matthew A Allison
• 金额: $ 64.15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8945851
• 关键词: Address; Adult; Affect; American; Ancillary Study; Area; Atherosclerosis; Behavioral; Blood Pressure; Buffers; Categories; Characteristics; Chronic stress; Clinical; Clinical assessments; Cohort Studies; Community Surveys; Comorbidity; Data; Data Collection; Data Sources; Diabetes Mellitus; Disease; Environment; Epidemic; Equation; Esthetics; Factor Analysis; Fasting; Geographic Information Systems; Health; Health Status; High Density Lipoprotein Cholesterol; High Prevalence; Hispanics; Home environment; Household; Income; Individual; Intervention; Latino; Life; Link; Longitudinal Studies; Mediating; Mediation; Mental Depression; Metabolic; Metabolic syndrome; Mexican; Mexican Americans; Modeling; Neighborhoods; Obesity; Outcome; Participant; Pathway interactions; Patient Self-Report; Physical activity; Population; Prevalence; Procedures; Psychosocial Factor; Research Infrastructure; Risk; Safety; Sampling; Site; Social Environment; Social support; Testing; Triglycerides; Visit; Vulnerable Populations; built environment; cohort; collaborative environment; combat; community health study; cost effective; density; experience; fasting glucose; improved; innovation; land use; novel; pandemic disease; primary outcome; psychosocial; public health relevance; response; social; tool; waist circumference

 DESCRIPTION (provided by applicant): Novel multi-level intervention strategies are needed to combat the burgeoning pandemics of diabetes, obesity and their related comorbidities among highly impacted populations. Neighborhood environments and Latino health have only been studied in one large cohort study to date, The Multi Ethnic Study of Atherosclerosis. We propose a cost-effective ancillary study, submitted in response to PAR-13-302, that leverages existing data from the Hispanic Community Health Study - Study of Latinos (HCHS-SOL), while adding comprehensive neighborhood environment assessments and Visit 2 physical activity assessments to this ongoing cohort study. The proposed study is timely because the rapidly growing Latino population, particularly Mexican Americans, experience disproportionally high rates of cardiometabloic diseases such as diabetes and obesity. In this study we will investigate neighborhood environment impacts on cardiometabolic health in the HCHS/SOL San Diego cohort (N = 1750 Mexican Americans) using an innovative and comprehensive Social-Ecological Model that considers multiple pathways linking both macro- and micro-scale built and social neighborhood factors to cardiometabolic health using a longitudinal framework. Six year trajectories in cardiometabolic outcomes will be derived from comprehensive clinical assessments during 2008-2011 (Visit 1) and 2015-2018 (Visit 2). Physical activity was/will be assessed at Visits 1 and 2 using accelerometry and validated self-report. Chronic stress and social support will be assessed using validated self-reports at Visit 2, while depression was/will be assessed at both visits. Macro-scale neighborhood attributes (e.g., residential density, median household income) will be derived from GIS and public source data such as the American Community Survey using 1km street-network buffers around participants' homes. Micro-scale attributes (e.g., safety of street crossings, aesthetics/social disorder) will be assessed using systematic direct observations of participants' neighborhoods. Both cross-sectional and longitudinal structural equation models will be used to investigate direct and indirect (through physical activity, depression, chronic stress, and social support) effects of neighborhood environments on a cardiometabolic composite score comprised of the Metabolic Syndrome components (i.e., waist circumference, systolic blood pressure, HDL-cholesterol, fasting glucose and fasting triglycerides). As posited in Social-Ecological Models, we powered this study to test mediation (through the aforementioned behavioral and psychosocial pathways) and interactions among neighborhood attributes (e.g., built and social). By improving understanding of neighborhood effects on Latino health, this project will inform health-supportive neighborhood interventions in high-need areas, as well as behavioral and psychosocial interventions to minimize the negative health impacts of unsupportive neighborhood environments.

 描述（由申请人提供）：需要采取新颖的多层次干预策略来对抗糖尿病、肥胖症及其相关合并症在受影响严重的人群中的迅速流行。迄今为止，仅在一项大型队列研究中对社区环境和拉丁裔健康进行了研究。我们提出了一项针对 PAR-13-302 提交的具有成本效益的辅助研究，该研究利用了西班牙社区健康研究的现有数据 -拉丁裔研究 (HCHS-SOL)，同时在这项正在进行的队列研究中添加了全面的社区环境评估和访问 2 体力活动评估。这项拟议的研究是及时的，因为快速增长的拉丁裔人口，特别是墨西哥裔美国人，心脏代谢疾病的发病率不成比例地高。在这项研究中，我们将使用创新且全面的社会生态模型来调查社区环境对 HCHS/SOL 圣地亚哥队列（N = 1750 名墨西哥裔美国人）心脏代谢健康的影响。使用纵向框架考虑将宏观和微观尺度的建筑因素和社会邻里因素与心脏代谢健康联系起来的多种途径，心脏代谢结果的六年轨迹将来自 2008-2011 年（访问 1）和 2015-2018 年（访问 1）期间的综合临床评估。访问 2) 已/将在访问 1 和 2 时使用加速度测量法和经过验证的慢性压力和社交进行评估。将使用第 2 次访问时经过验证的自我报告来评估支持度，而在两次访问中将评估抑郁症 宏观尺度的社区属性（例如住宅密度、家庭收入中位数）将来自 GIS 和公共源数据，例如。美国社区调查使用参与者家周围 1 公里的街道网络缓冲区，将通过对参与者社区的横断面和纵向的系统直接观察来评估微观属性（例如，街道交叉口的安全性、美观/社会混乱）。结构方程模型将用于研究邻里环境对由代谢综合征组成部分（即腰围、收缩压、HDL-正如社会生态模型中所假设的那样，我们支持这项研究来测试中介（通过提到的行为和心理社会途径）和邻里属性之间的相互作用。 （例如，建筑和社会）。通过提高对社区对拉丁裔健康影响的了解，该项目将为高需求地区的健康支持社区干预措施以及行为和社会心理干预措施提供信息，以尽量减少不支持的社区环境对健康的负面影响。 。