The Study on Type-2 Diabetes and the Rural Experience regarding Stress and Self-management behaviors (STRESS) Project

2 型糖尿病研究以及关于压力和自我管理行为（STRESS）项目的农村经验

• 批准号: 10690211
• 负责人: Idethia Shevon Harvey
• 金额: $ 17.72万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-14 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10690211
• 关键词: Address; Adopted; Adverse event; Affect; African American; Amputation; Area; Attention; Behavior; Behavior Therapy; Behavioral; Biological; Biological Assay; Biological Markers; Biomedical Research; Biosocial; Blindness; Chronic Disease; Chronic stress; Collection; Complex; Consensus; Data; Diabetes Mellitus; Diagnosis; Discrimination; Disease; Event; Exposure to; Geography; Goals; Health; Health Status; Health behavior; Healthy People 2020; Hydrocortisone; Hypertension; Individual; Infrastructure; Institutes; Kidney Diseases; Kidney Failure; Light; Link; Literature; Measures; Mediating; Mission; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Patient Self-Report; Persons; Physiological; Pilot Projects; Population; Poverty; Predictive Value; Prevalence; Psychosocial Factor; Psychosocial Stress; Public Health; Race; Reduce health disparities; Reporting; Research; Research Methodology; Research Project Grants; Research Proposals; Risk Factors; Role; Rural; Rural Community; Rural Health; Rural Minority; Rural Population; Saliva; Salivary; Sampling; Self Management; Shapes; Stress; Surveys; Testing; Work; community engaged research; contextual factors; cost; diabetes self-management; experience; glucose metabolism; hypothalamic-pituitary-adrenal axis; innovation; minority communities; perceived stress; prevent; psychobiologic; psychobiology; psychological distress; psychosocial; public health priorities; recruit; rural African American; rural area; self-management program; social; social culture; social factors; stress management; stressor; urban area; virtual

PROJECT SUMMARY/ABSTRACT The prevalence of type 2 diabetes (T2D) is 17% higher in rural areas than in urban areas. Additionally, T2D is ranked as the third most important rural public health priority, according to the Rural Healthy People 2020 report. Rural populations are disproportionately affected by preventable chronic diseases exacerbated by social contextual factors such as poverty, geographic isolation, and persistent exposure to stressors in daily living. Together, these factors may have a negative impact on T2D self-management (T2D-SM) behaviors. Behavioral explanations for rural African Americans’ (RAAs) self-management behaviors, with virtually no research attention has been paid to the role of social factors. Stress is a particularly compelling area of study in light of strong evidence demonstrating its linkages to chronic diseases and conditions such as hypertension and obesity. The goal of this proposal is to determine which stressors (i.e., general versus domain-specific) are an important risk factor for T2D-SM behaviors. This project will adapt the Environmental Affordances Model to explore the mediating, moderating, and interactions among biosocial and environmental contextual factors shaping T2D-SM behaviors. The study builds upon a robust infrastructure from community-engaged research in the Brazos Valley region to explore the inclusion of biological assays for stress (e.g., salivary cortisol) among RAAs with T2D. The two specific aims that guide this research proposal are: 1) to determine the extent to which psychosocial stress explain differences in T2D self-management behaviors among RAAs with T2D; and 2) to determine the relationship between psychosocial stress and physiological stress markers (e.g., cortisol) from RAAs with T2D. The study will recruit 200 RAAs, who have been diagnosed with T2D, to determine which stressors are an important risk factors for self-management behaviors. For Aim 1, The study will collect and analyze subjective measures of stress, health status, psychosocial factors, and diabetes self-management behaviors. For Aim 2, The study will examine the association between salivary cortisol, self-reported stressors, and T2D-SM behaviors. The research proposed is innovative, in the applicants’ opinion, because it addresses an important public health problem (i.e., stress and discrimination) among RAAs, which has largely been ignored, within the context of rural communities and disease self-management. The proposed research is significant because it is expected to provide strong evidence of psychosocial stress and physiological stress measures on T2D-SM behaviors. The results of this research project can offer considerable contributions to the public health field because it has the potential to shed new light on the health of rural African Americans.

项目摘要/摘要 在粗糙地区，2型糖尿病（T2D）的患病率比市区高17％。另外，T2D是 根据乡村健康人民2020年，被评为第三重要的农村公共卫生优先事项 报告。农村人口受到可预防的慢性疾病的影响不成比例的 社会背景因素，例如贫困，地理隔离和日常压力源的持续暴露 活的。总之，这些因素可能对T2D自我管理（T2D-SM）行为产生负面影响。 对粗糙的非裔美国人（RAAS）自我管理行为的行为解释，几乎没有 对社会因素的作用引起了研究的关注。压力是一个特别令人信服的研究领域 有力的证据证明了其与慢性疾病和高血压等疾病的联系 和肥胖。该建议的目的是确定哪些压力源（即一般和特定领域）是 T2D-SM行为的重要危险因素。该项目将使环境提供模型适应 探索生物社会和环境背景因素之间的中介，调节和相互作用 塑造T2D-SM行为。该研究以社区参与研究的强大基础设施为基础 在布拉索斯山谷地区，探索包括压力的生物测定法（例如唾液皮质醇） 带有T2D的RAA。指导该研究建议的两个具体目标是：1）确定 哪种社会心理压力解释了T2D的RAA中T2D自我管理行为的差异；和 2）确定心理压力和身体应力标记（例如皮质醇）之间的关系 来自带有T2D的Raas。该研究将招募200名被诊断为T2D的RAA，以确定 哪些压力源是自我管理行为的重要危险因素。对于目标1，研究将收集 并分析压力，健康状况，社会心理因素和糖尿病自我管理的主观度量 行为。对于AIM 2，该研究将检查唾液皮质醇，自我报告的压力源之间的关联， 和T2D-SM行为。申请人认为，提出的研究是创新的，因为它解决了 RAAS中的一个重要的公共卫生问题（即压力和歧视），这在很大程度上是 在农村社区和疾病自我管理的背景下被忽略。拟议的研究是 重要的是因为预计将提供有力的社会心理压力和身体压力的证据 T2D-SM行为的措施。该研究项目的结果可以为 公共卫生领域是因为它有可能对粗糙的非洲裔美国人的健康阐明。