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: 9464303
• 负责人: Matthew A Allison
• 金额: $ 10.98万
• 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/9464303
• 关键词: Accelerometer; Address; Adult; Affect; American; Ancillary Study; Area; 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; Hispanic Community Health Study/Study of Latinos; Hispanics; Home environment; Household; Income; Individual; Intervention; Latino; Link; Longitudinal Studies; Mediating; Mediation; Mental Depression; Metabolic; Metabolic syndrome; Mexican; Mexican Americans; Modeling; Multi-Ethnic Study of Atherosclerosis; 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; Study of Latinos; Testing; Time; Triglycerides; Visit; Vulnerable Populations; built environment; cohort; collaborative environment; combat; cost effective; density; experience; fasting glucose; improved; innovation; land use; multilevel analysis; 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（由适用提供）：需要新颖的多层干预策略来应对糖尿病，肥胖症及其相关人群中相关的合并症的大流行。迄今为止，仅在一项大型同类研究中研究了邻里环境和拉丁裔健康，即动脉粥样硬化的多民族研究。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裔社区健康研究的现有数据 - 拉丁美洲裔研究（HCHS-SOL），同时添加了全面的社区环境评估，并访问了这项正在进行的队列研究的2种体育活动评估。拟议的研究之所以及时，是因为迅速增长的拉丁裔人口，尤其是墨西哥裔美国人，经历了诸如糖尿病和肥胖症等心脏多余的疾病率不成比例的。在这项研究中，我们将使用一种创新且全面的社会生态模型来研究邻里环境对HCHS/SOL SOL SAN DIEGO队列（n = 1750墨西哥裔美国人）的心脏代谢健康的影响，该模型将多种途径链接到宏观和微观尺度和微型型构建和社交邻里和社交社区因素与使用纵向代谢型健康框架的宏观构建和社交邻里因素。心脏代谢结果的六年轨迹将来自2008 - 2011年期间的综合临床评估（访问1）和2015-2018（访问2）。将使用加速度测定法和经过验证的自我报告在访问1和2上评估体育活动。慢性压力和社会支持将在访问2时使用经过验证的自我报告进行评估，而两次访问时都将评估抑郁症。宏观级社区属性（例如，住宅密度，家庭收入中位数）将源自GIS和公共来源数据，例如使用参与者的房屋周围的1公里的街道网络缓冲区，例如美国社区调查。将使用对参与者社区的系统直接观察来评估微观级属性（例如，街道交叉的安全性，美学/社会障碍）。横截面和纵向结构等效模型都将用于研究邻里环境对邻里环境的直接和间接（通过体育锻炼，抑郁，慢性压力和社会支持）对代谢综合征成分的心脏代谢复合评分的影响（即腰围，腰围，高压血压，HDL-胆固醇，快速粘贴症和快速固定器）。正如社会生态模型所提出的那样，我们为这项研究提供了动力，以测试调解（通过优先的行为和社会心理途径）和邻里属性之间的相互作用（例如，建造和社会）。通过提高对邻里对拉丁裔健康的影响的了解，该项目将为健康支持的邻里干预措施以及行为和社会心理干预措施，以最大程度地减少不支持邻里环境的负面影响。