Psychosocial Factors and Lupus Disease Progression Among African American Women

非裔美国女性的心理社会因素和狼疮疾病进展

基本信息

批准号：
10690156
负责人：
H. David Chae
金额：
$ 67.43万
依托单位：
TULANE UNIVERSITY OF LOUISIANA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10690156
关键词：
Address Affect African American Age Aging Biological Biological Markers Blood Buffers C-reactive protein Cardiovascular system Cell Aging Child Rearing Chronic Chronic Disease Clinical Clinical Trials Communities Data Data Collection Disadvantaged Discrimination Disease Disease Management Disease Pathway Disease Progression Face Family Relationship Financial Hardship Gender Health Immune Inflammation Inflammatory Infrastructure Intervention Investigation Kidney Knowledge Length Leukocytes Linear Models Link Longitudinal Studies Lupus Lupus Erythematosus Measures Methods Modeling Nature Neighborhoods Organ Outcome Participant Pathway interactions Patients Pattern Physicians Physiological Population Population Study Poverty Prevalence Privatization Process Psychosocial Assessment and Care Psychosocial Factor Psychosocial Stress Recording of previous events Religion and Spirituality Research Research Design Resources Role Sample Size Science Severities Severity of illness Social Environment Social support Socialization Source Spottings Stress Systemic Lupus Erythematosus Techniques Testing Tissues Universities Venipunctures Woman Work caregiving chronic autoimmune disease cohort comorbidity cytokine experience improved longitudinal design minimally invasive mortality multidisciplinary population based protective factors psychobiologic psychologic psychosocial psychosocial resources psychosocial stressors racial discrimination racial disparity racial identity racial minority recruit response social factors social health determinants socioeconomics stress management stressor systemic inflammatory response telomere young woman

项目摘要

PROJECT SUMMARY/ABSTRACT There is a lack of research on systematic lupus erythematosus (SLE), a multisystem, chronic, autoimmune disease that shows clear patterns along racial and gender lines. African American women not only have a greater prevalence of SLE, but also experience greater severity and faster progression compared to their White counterparts, being more frequently affected by organ damage and comorbid conditions that emerge as a consequence of disease activity and disease-related chronic inflammation and tissue damage. Racial disparities in SLE complications and mortality are well documented; however, the reasons for these disparities are poorly understood. To address these gaps in knowledge, this study aims to: (1) examine the role that psychosocial stressors experienced by African American women have in exacerbating SLE in this population; (2) identify social factors and psychological resources that are protective or buffer the effects of stress on SLE-related health declines; and (3) explore the biological implications of psychosocial stressors and SLE, in relation to elevated systemic inflammation and accelerated aging at the cellular level. The experiences of African American women with SLE are particularly challenging, and include psychosocial stressors related to disease management, as well as disproportionately greater poverty and living in disadvantaged communities; in addition to routine stressors such as those associated with work, family and relationship demands, parenting, and caregiving. Experiences of racial discrimination constitute a qualitatively distinct source of psychosocial stress, adding to existing everyday hassles. In this study, we will examine how these stressors impact SLE severity and progression through a longitudinal study design. We will collect three waves of data from 480 African American women, all with validated SLE. Participants will be recruited from the Georgians Organized Against Lupus (GOAL) cohort, a truly one-of-a-kind, population-based study of SLE in Atlanta, including a full spectrum of patients from all levels of socioeconomic strata, across a range of disease severity. We will examine the effects of racial discrimination, financial and neighborhood-related strains, and other stressors associated with various role strains. Potential protective factors, including those related to racial identity and social support, will also be assessed. We will collect dried blood spots (DBS), a minimally invasive alternative to venipuncture, to examine indicators of biological dysregulation which we hypothesize will be impacted by psychosocial stress as well as SLE activity. This study will be the most in-depth investigation of the multifactorial nature of psychosocial stressors and their impact on SLE disease progression among African American women, and thus fills an important gap in the science on this understudied disease. This research is important in advancing knowledge of how aspects of the social environment and psychological processes impact health among African American women with SLE, and also contributes to scientific knowledge on the underpinnings of racial disparities in the progression of this disease.

项目概要/摘要系统性红斑狼疮（SLE）是一种多系统、慢性、自身免疫性疾病在种族和性别方面表现出明显的模式。非裔美国女性则不然与相比，系统性红斑狼疮不仅患病率更高，而且严重程度更高、进展更快与白人同行相比，他们更频繁地受到器官损伤和合并症的影响，由于疾病活动以及与疾病相关的慢性炎症和组织损伤而出现。 SLE 并发症和死亡率的种族差异已有充分记录；然而，造成这些现象的原因人们对差异知之甚少。为了解决这些知识差距，本研究旨在：（1）检查角色非裔美国女性所经历的社会心理压力会加剧系统性红斑狼疮人口; (2) 识别保护或缓冲影响的社会因素和心理资源与系统性红斑狼疮相关的健康状况下降的压力； (3) 探索社会心理压力源的生物学影响 SLE，与细胞水平的全身炎症升高和加速衰老有关。患有系统性红斑狼疮的非裔美国女性的经历尤其具有挑战性，包括与疾病管理相关的社会心理压力源以及不成比例的贫困和生活在弱势社区；除了日常的压力源，例如与工作、家庭和关系要求、养育和照顾。种族歧视的经历构成了定性的社会心理压力的独特来源，增加了现有的日常麻烦。在本研究中，我们将研究如何这些压力因素通过纵向研究设计影响系统性红斑狼疮的严重程度和进展。我们将收集三个来自 480 名非洲裔美国女性的数据浪潮，她们都患有经过验证的 SLE。参与者将从格鲁吉亚抗狼疮组织 (GOAL) 队列是一项真正独一无二的、基于人群的 SLE 研究亚特兰大，包括来自社会经济各阶层、患有多种疾病的各种患者严重程度。我们将研究种族歧视、经济和邻里相关压力的影响，以及与各种角色压力相关的其他压力源。潜在的保护因素，包括与种族有关的因素身份和社会支持也将被评估。我们将收集干血斑（DBS），这是一种微创技术静脉穿刺的替代方案，以检查我们假设的生物失调指标受社会心理压力和 SLE 活动的影响。这项研究将是最深入的调查非洲人社会心理压力源的多因素性质及其对 SLE 疾病进展的影响美国女性，从而填补了这一未充分研究的疾病的科学空白。这项研究是对于增进对社会环境和心理过程的各个方面的了解非常重要影响患有系统性红斑狼疮的非洲裔美国妇女的健康，也有助于增进有关该疾病的科学知识这种疾病进展中种族差异的基础。

项目成果

期刊论文数量（18）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Anticipatory racism stress, smoking and disease activity: the Black women's experiences living with lupus (BeWELL) study.

预期种族主义压力、吸烟和疾病活动：黑人女性狼疮患者的经历 (BeWELL) 研究。

DOI：
10.1007/s10865-021-00235-9
发表时间：
2021
期刊：
Journal of behavioral medicine
影响因子：
3.1
作者：
Spears,EricaC;Allen,AmaniM;Chung,KaraW;Martz,ConnorD;Hunter,EvelynA;Fuller-Rowell,ThomasE;Lim,SSam;Drenkard,Christina;Chae,DavidH
通讯作者：
Chae,DavidH

Pathways linking census tract typologies with subjective neighborhood disorder and depressive symptoms in the Black Women's Experiences Living with Lupus (BeWELL) Study.

DOI：
10.1016/j.healthplace.2021.102587
发表时间：
2021-07
期刊：
Health & place
影响因子：
4.8
作者：
Martz CD;Hunter EA;Kramer MR;Wang Y;Chung K;Brown M;Drenkard C;Lim SS;Chae DH
通讯作者：
Chae DH

Association of age with health-related quality of life in a cohort of patients with systemic lupus erythematosus: the Georgians Organized Against Lupus study.

DOI：
10.1136/lupus-2016-000161
发表时间：
2016
期刊：
Lupus science & medicine
影响因子：
3.9
作者：
Plantinga L;Lim SS;Bowling CB;Drenkard C
通讯作者：
Drenkard C

Comparison of quality-of-care measures in U.S. patients with end-stage renal disease secondary to lupus nephritis vs. other causes.

美国继发于狼疮性肾炎的终末期肾病患者与其他原因所致的终末期肾病患者的护理质量措施比较。

DOI：
10.1186/s12882-015-0037-1
发表时间：
2015
期刊：
BMC nephrology
影响因子：
2.3
作者：
Plantinga,LauraC;Patzer,RachelE;Drenkard,Cristina;Pastan,StephenO;Cobb,Jason;McClellan,William;Lim,SungSam
通讯作者：
Lim,SungSam

Depression, stigma and social isolation: the psychosocial trifecta of primary chronic cutaneous lupus erythematosus, a cross-sectional and path analysis.