Built environments on stroke risk and stroke disparities in a national sample

全国样本中关于中风风险和中风差异的构建环境

• 批准号: 9207809
• 负责人: NATALIE COLABIANCHI
• 金额: $ 62.49万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9207809
• 关键词: Address; Adult; African American; Age; American; American Heart Association; Area; Cardiovascular Diseases; Case Fatality Rates; Cause of Death; Characteristics; Chronic Disease; Cohort Studies; Communities; Coronary heart disease; Cost Measures; Country; Crime; Data; Data Collection; Data Set; Data Sources; Death Rate; Destinations; Development; Diabetes Mellitus; Dietary intake; Disease; Disease Outcome; Documentation; Environment; Environmental Risk Factor; Food; Future; Geography; Goals; Incidence; Individual; Institution; Intervention; Investigation; Link; Measures; Methods; Modification; Neighborhoods; Not Hispanic or Latino; Parents; Participant; Patient Self-Report; Persons; Physical activity; Physical environment; Planet Earth; Price; Protocols documentation; Race; Research; Research Personnel; Rest; Risk; Risk Factors; Role; Safety; Sampling; Secure; Social Environment; Social Network; Social support; Socioeconomic Status; Source; Southeastern United States; Stroke; Stroke prevention; United States; United States National Institutes of Health; aging population; behavioral outcome; built environment; cardiovascular risk factor; cohesion; cohort; community setting; cost effective; data sharing; disability; effective intervention; experience; geographic difference; improved; land use; member; mortality; novel; population health; public health relevance; racial difference; racial disparity; segregation; social; walkability; Address; Adult; African American; Age; American; American Heart Association; Area; Cardiovascular Diseases; Case Fatality Rates; Cause of Death; Characteristics; Chronic Disease; Cohort Studies; Communities; Coronary heart disease; Cost Measures; Country; Crime; Data; Data Collection; Data Set; Data Sources; Death Rate; Destinations; Development; Diabetes Mellitus; Dietary intake; Disease; Disease Outcome; Documentation; Environment; Environmental Risk Factor; Food; Future; Geography; Goals; Incidence; Individual; Institution; Intervention; Investigation; Link; Measures; Methods; Modification; Neighborhoods; Not Hispanic or Latino; Parents; Participant; Patient Self-Report; Persons; Physical activity; Physical environment; Planet Earth; Price; Protocols documentation; Race; Research; Research Personnel; Rest; Risk; Risk Factors; Role; Safety; Sampling; Secure; Social Environment; Social Network; Social support; Socioeconomic Status; Source; Southeastern United States; Stroke; Stroke prevention; United States; United States National Institutes of Health; aging population; behavioral outcome; built environment; cardiovascular risk factor; cohesion; cohort; community setting; cost effective; data sharing; disability; effective intervention; experience; geographic difference; improved; land use; member; mortality; novel; population health; public health relevance; racial difference; racial disparity; segregation; social; walkability

 DESCRIPTION (provided by applicant): Stroke is one of the leading causes of death and a top cause of serious long-term disability. A number of stroke risk factors have been established at the individual-level; however, these risk factors only partially explain stroke risk and account for only half of the racial disparities in stroke. Novel exposures of stroke risk must be identifie to improve our understanding of stroke risk and to develop effective interventions. Recently, built and social environments (BSEs) have been identified as important factors to examine to further our understanding of cardiovascular disease. However, to date no studies have examined the effect of BSEs on stroke risk. BSEs may also help to explain the large racial and geographic disparities in stroke rates although this has yet to be empirically examined nationally. The proposed study would address these gaps by utilizing a unique assembled cohort, namely the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The REGARDS cohort is a national sample of adults over age 45, with oversamples of African-American participants and persons in the stroke belt. The proposed study will expand the REGARDS study to examine the effects of BSEs on incident stroke risk and on racial and geographic disparities in stroke. These aims will be achieved by obtaining data on a broad range of BSE characteristics of the REGARDS participants' built environment (e.g., food availability, park availability, food prices, physical activity facility availability, land use, steet connectivity and neighborhood physical environment) and participants' social environment (objective crime, perceived crime, neighborhood SES, social cohesion, racial residential segregation, social support and social networks, and neighborhood social environment). The data will be obtained from a number of sources including secondary commercial and administrative sources, participant self-reports and primary audits using the Street View feature in Google Earth. Environmental data will be spatially linked to participant data of the REGARDS case-cohort study. The proposed study aims to 1) examine the extent to which BSEs contribute to incident stroke risk in the REGARDS study; and 2) determine the extent to which BSEs explain racial and geographic disparities in incident stroke. The proposed study builds on important preliminary studies and the extensive relevant experience of the investigative team, which includes prominent scholars across a number of institutions. The proposed research provides a cost-effective way to examine the importance of BSEs for stroke prevention across diverse community settings and racial groups. Identifying the BSE characteristics that are predictive of incident stroke and BSEs that contribute to racial and geographic disparities will help inform future modifications of environments to improve population health. At the end of the study period, the BSE data will be made available to others through the REGARDS data sharing protocols; thus the measures in the proposed study will be available to the greater scientific community for use in research pertaining to other disease outcomes.

 描述（由适用提供）：中风是死亡的主要原因之一，也是严重长期残疾的主要原因。在个人级别上已经建立了许多中风风险因素；但是，这些风险因素仅部分解释中风风险和帐户 只有一半的中风分布。必须确定中风风险的新型暴露，以提高我们对中风风险的理解并制定有效的干预措施。最近，建造和社会环境（BSE）被确定为研究的重要因素，可以进一步了解我们对心血管疾病的理解。但是，迄今为止，尚无研究检查BSE对中风风险的影响。 BSE还可能有助于解释中风率的巨大种族和地理差异，尽管这尚未在全国范围内进行经验研究。拟议的研究将通过利用独特的组装队列来解决这些差距，即中风和种族差异的原因（有关）队列。拟议的研究将扩大研究的研究，以检查BSE对事件中风风险以及中风中种族和地理分布的影响。这些目标将通过获取有关参与者建筑环境的广泛特征的数据（例如，食品可用性，公园可用性，食品价格，食品价格，体育活动设施的可用性，土地利用，地板连通性和邻里的身体环境）以及参与者的社交环境（客观犯罪，邻里犯罪，社会犯罪，社会阵容，社会群体，种族居民，社交环境和社会社交，社交，社交），社交，社交，社交，社交，社交，社交，社交，社交，社交，社交，社会环境和社会。这些数据将从许多来源获得，包括二级商业和行政资源，使用Google Earth中的Street View功能参与的自我报告和主要审核。环境数据将在空间上与案例研究研究的参与数据有关。拟议的研究旨在1）检查BSE在研究方面对事件中风风险的贡献程度； 2）确定BSE在事件中风中解释种族和地理分布的程度。拟议的研究以重要的初步研究和调查团队的广泛相关经验为基础，其中包括许多机构的杰出学者。拟议的研究提供了一种具有成本效益的方式来研究BSE在潜水员社区环境和种族群体中预防中风的重要性。确定可预测导致种族和地理差异的事件中风和BS的BSE特征将有助于为未来的环境修改以改善人口健康。在研究期结束时，将通过数据共享协议向他人提供BSE数据；因此，拟议的研究中的措施将用于更大的科学界，以用于与其他疾病结果有关的研究。