The Impact of a Race-Based Stress Reduction Intervention on Well-Being, Inflammation, and DNA methylation in Older African American Women at Risk for Cardiometabolic Disease

基于种族的减压干预措施对有心血管代谢疾病风险的老年非洲裔美国女性的健康、炎症和 DNA 甲基化的影响

• 批准号: 10633624
• 负责人: Karen Lynn Saban
• 金额: $ 67.89万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633624
• 关键词: Address; African American; African American population; Age Years; Behavioral; Biological; Buffers; C-reactive protein; Candidate Disease Gene; Cardiometabolic Disease; Cardiovascular Diseases; Cessation of life; Chicago; Chronic; Chronic Disease; Chronic stress; Cognitive; Coping Skills; Coronary Arteriosclerosis; DNA; DNA Methylation; DNA Modification Process; Data; Development; Discrimination; Disease; Emotional; Environment; Epigenetic Process; Ethnic Origin; Ethnic Population; Exhibits; Face; Fatigue; Gene Expression; Genes; Goals; Health; Health education; High Prevalence; Hypertension; Individual; Inflammation; Inflammatory; Inflammatory Response Pathway; Interferon Type II; Interleukin-1 beta; Interleukin-6; Intervention; Investigation; Life Stress; Link; Longevity; Measures; Methylation; Minority; Minority Women; Molecular; New York City; Obesity; Outcome; Participant; Personal Satisfaction; Prediabetes syndrome; Problem Solving; Psychological Impact; Psychological Stress; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Resistance; Risk; Risk Factors; Salivary; Sexism; Sleep disturbances; Social support; Stress; Symptoms; TNF gene; Validation; Well in self; Woman; Work; acute stress; allostatic load; attentional control; biological adaptation to stress; biopsychosocial; cardiometabolic risk; coping; cytokine; depressive symptoms; disorder risk; effective intervention; effectiveness evaluation; empowerment; experience; health disparity; high risk population; improve minority health; improved; innovation; methyl group; mortality risk; novel; older women; perceived discrimination; post intervention; programs; psychologic; psychological distress; racial identity; racial population; racism; recruit; resilience; response; sex; stress reduction; stressor; theories

PROJECT SUMMARY This randomized controlled trial will evaluate the impact of a novel race-based stress reduction program on well-being, inflammatory burden, and DNA methylation (DNAm) in older African American (AA) women at risk for cardiometabolic disease (CMD). Although the number of deaths related to CMD continues to decline, that decline has slowed recently with AAs bearing a disproportionate burden. Furthermore, women face more sex- specific risk factors for increased adiposity and AA women have the highest prevalence of obesity, hypertension, and prediabetes compared to all other racial and ethnic groups. Chronic stress is associated with low-grade inflammation and increased CMD risk. Growing evidence demonstrates that stressors such as racism and discrimination are significant contributing factors to psychological distress, low-grade chronic inflammation, and CMD health disparities among minorities, particularly among older AA women who endure the intersection of both racism and sexism across their lifespan. Resilience, Stress, and Ethnicity (RiSE) is a group-based, 8-week intervention that integrates cognitive-behavioral strategies focused on the biopsychosocial impact of racism, racial identity development, and empowerment. Based on our preliminary work, we anticipate that participation in RiSE will reduce psychological distress and inflammation. Further, our previous work demonstrated that women with high levels of perceived discrimination have a greater proinflammatory cytokine response to acute stress and decreased DNAm of genes related to inflammation and hypertension. DNAm is one type of epigenetic process that modulates gene expression by adding or removing methyl groups to DNA in response to the environment. Studies demonstrate that hyper or hypo methylation of genes due chronic stressors, including racism and discrimination are significantly associated with CMD risk. Emerging evidence demonstrates that psychobehavioral interventions may modify methylation of stress response-related genes potentially buffering the impact of psychological stress at the molecular level. However, few studies have examined the impact of a psychobehavioral intervention on changes in DNAm and none have addressed chronic stress in older AA women.Therefore, the specific aims are: (1) Determine the extent to which participation in RiSE decreases stress-related symptoms and inflammatory burden in older AA women at risk for CMD; (2) Evaluate the extent to which RiSE increases the use of adaptive coping versus maladaptive coping strategies in older AA women at risk for CMD; and (3) Determine the extent to which participation in RiSE modifies DNAm of stress response- related candidate genes in older AA women at risk for CMD from baseline to post RiSE intervention. AA women 50 to 70 years of age who are at risk for CMD will be randomized into either an 8-week RiSE program or a health education program. RiSE is an innovative intervention that addresses perceived racism and discrimination at the individual level. Further, RiSE has the potential to improve the health of minority women impacted by racism and discrimination.

项目概要 这项随机对照试验将评估一种新颖的基于种族的减压计划对 面临风险的老年非洲裔美国 (AA) 女性的健康状况、炎症负担和 DNA 甲基化 (DNAm) 用于心脏代谢疾病（CMD）。尽管 CMD 相关死亡人数持续下降，但 由于AA承担着不成比例的负担，下降速度最近有所放缓。此外，女性面临更多的性行为—— 肥胖增加的特定危险因素，AA 女性肥胖患病率最高， 与所有其他种族和族裔群体相比，高血压和糖尿病前期。慢性压力与 低度炎症和 CMD 风险增加。越来越多的证据表明，压力源，例如 种族主义和歧视是导致心理困扰、低度慢性病的重要因素 少数族裔之间的炎症和 CMD 健康差异，尤其是患有 AA 的老年女性 种族主义和性别歧视在他们一生中的交叉点。复原力、压力和种族 (RiSE) 是 基于小组的为期 8 周的干预，整合了侧重于以下方面的认知行为策略： 种族主义、种族认同发展和赋权的生物心理社会影响。根据我们的初步 工作中，我们预计参与 RiSE 将减少心理困扰和炎症。此外，我们的 先前的研究表明，遭受高度歧视的女性有更大的风险 促炎细胞因子对急性应激的反应以及与炎症和相关基因的 DNAm 减少 高血压。 DNAm 是一种表观遗传过程，通过添加或删除来调节基因表达 DNA 上的甲基对环境作出反应。研究表明，高甲基化或低甲基化 慢性压力源（包括种族主义和歧视）引起的基因与 CMD 风险显着相关。 新的证据表明，心理行为干预可能会改变压力的甲基化 反应相关基因可能在分子水平上缓冲心理压力的影响。 然而，很少有研究探讨心理行为干预对 DNAm 和 DNAm 变化的影响。 没有一个能够解决老年 AA 女性的慢性压力问题。因此，具体目标是： (1) 确定 参与 RiSE 在多大程度上可以减轻老年 AA 的压力相关症状和炎症负担 有 CMD 风险的女性； (2) 评估 RiSE 在多大程度上增加了适应性应对的使用 有 CMD 风险的老年 AA 女性的适应不良应对策略； (3) 确定在多大程度上 参与 RiSE 改变了有风险的老年 AA 女性的应激反应相关候选基因的 DNAm 从基线到 RiSE 干预后的 CMD。 50 至 70 岁有 CMD 风险的 AA 女性将 随机分为为期 8 周的 RiSE 计划或健康教育计划。 RiSE 是一项创新 解决个人层面上的种族主义和歧视问题的干预措施。此外，RiSE 还具有 改善受种族主义和歧视影响的少数群体妇女健康的潜力。