Systems Science Informed Multilevel Theoretical Model of Cardiovascular Health in Native Hawaiians

系统科学为夏威夷原住民心血管健康提供多层次理论模型

• 批准号: 10375444
• 负责人: Claire Townsend Ing
• 金额: $ 19.21万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10375444
• 关键词: Acculturation; Address; Adult; Age; Alcohol consumption; Area; Behavioral; Biological; Blood Pressure; Body mass index; Cardiovascular Diseases; Characteristics; Child; Communities; Complex; Coronary heart disease; Data; Data Collection; Demographic Factors; Development; Development Plans; Diet; Discrimination; Education; Educational workshop; Employment; Event; Exercise; Family; Fibrinogen; Focus Groups; Food; Funding; General Population; Goals; Health; Height; Household; Hypertension; Income; Indigenous; Individual; Intervention; Knowledge; Link; Mentors; Methods; Myocardial Infarction; Native Hawaiian; Obesity; Outcome; Persons; Physical activity; Population; Positioning Attribute; Principal Investigator; Process; Psychosocial Factor; Recording of previous events; Reduce health disparities; Research; Research Personnel; Research Support; Risk; Risk Factors; Science; Scientist; Stroke; Structure; System; Testing; Theoretical model; Tobacco use; Training; Translational Research; Unhealthy Diet; United States Department of Agriculture; Ursidae Family; Weight; base; behavior change; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; career; career development; community based participatory research; community engagement; community-level factor; design; disease disparity; experience; fast food; feasibility testing; food environment; food insecurity; health disparity populations; high risk; hypertension prevention; improved; model building; novel; physical inactivity; preventive intervention; protective factors; psychosocial; recruit; research and development; skills; social structure; sociodemographic factors; sociodemographics; theories; therapy design; walkability

PROJECT SUMMARY The purpose of this K01 application is to support the research and career development of Dr. Claire Townsend Ing in establishing herself as an independent investigator engaging community and using system science theory and methods to examine and address multilevel determinants of cardiovascular disease. Native Hawaiians bear a disproportionate burden of hypertension and cardiovascular disease. Culturally tailored interventions guided by psychosocial theories are effective at producing individual behavior change to improve health outcomes, but multilevel interventions are needed to expand and sustain these improvements. Multilevel interventions are particularly relevant for hypertension prevention as blood pressure is influenced by risk and protective factors at individual, family, community, societal, and environmental levels. However, research examining these factors' complex interactions and processes is lacking in Native Hawaiians. Such information is critical to developing a multilevel theoretical model of Native Hawaiian cardiovascular health to guide the design of culturally relevant, multi-level interventions for this understudied group. Dr. Ing will build on her experience in community-based participatory and translational research to achieve four short-term career objectives; to improve her knowledge and skill in 1) the scientifically rigorous examination of multilevel determinants of cardiovascular health, 2) systems science theory and methods to include group-based model building and community-based system dynamics, 3) hypertension and CVD prevention, and 4) Native Hawaiian community engagement. The proposed research will build on a partnership with a USDA-funded study (Children's Healthy Living Center of Excellence) that includes 6 Native Hawaiian communities. Its 2019 reassessment will include sociodemographic, psychosocial, behavioral, household, and community factors. Through leveraging this partnership, Dr. Ing will recruit 240 adults for additional data collection on blood pressure, height, weight, and behavioral and psychosocial factors (e.g., diet, physical activity, discrimination). Using these data, she will examine the relationships between individual, household, and community factors and blood pressure. Additionally, she will engage community leaders in 6 focus group workshops (n=48) to create causal structures of perceived links between multilevel factors and HTN. She will then synthesize the qualitative data and causal structures to create a causal loop diagram. This causal loop diagram will serve as a novel theoretical model of cardiovascular health in Native Hawaiians. The specific aims are: 1) to estimate the associations between behavioral (physical activity, diet, alcohol consumption, tobacco use), biological (BMI), psychosocial (acculturation, discrimination), household (size, composition, food scarcity, use of food assistance), and community (walkability, food environment) factors and blood pressure in 240 adult Native Hawaiians, and 2) engage community leaders via focus group workshops to create a causal loop diagram depicting multilevel determinants of cardiovascular health in Native Hawaiian communities.

项目摘要 该K01申请的目的是支持Claire Townsend博士的研究和职业发展 建立自己是一个独立的研究者参与社区并使用系统科学的独立研究者 研究和解决心血管疾病多层次决定因素的理论和方法。本国的 夏威夷人承担高血压和心血管疾病的负担不成比例。量身定制的文化 以社会心理理论为指导的干预措施有效地产生个人行为改变以改善 健康结果，但是需要进行多层次干预来扩大和维持这些改进。多级 干预措施与预防高血压特别相关，因为血压受风险和 个人，家庭，社区，社会和环境水平的保护因素。但是，研究 夏威夷原住民缺乏检查这些因素的复杂相互作用和过程。这样的信息 对于开发夏威夷本地心血管健康的多层次理论模型至关重要 对这个研究群体的文化相关，多层次干预的设计。 Ing博士将建立在她的基础上 具有基于社区的参与性和转化研究的经验，可以实现四个短期职业 目标；为了提高她的知识和技巧1）对多级的科学严格检查 心血管健康的决定因素，2）系统科学理论和包括基于群体模型的方法 建筑物和基于社区的系统动力学，3）高血压和CVD预防，4）本地 夏威夷社区参与。拟议的研究将与美国农业部资助的合作伙伴关系建立 研究（儿童健康生活中心卓越中心），其中包括6个夏威夷本地社区。它的2019年 重新评估将包括社会人口统计学，社会心理，行为，家庭和社区因素。 通过利用这种合作伙伴关系，ING博士将招募240名成年人进行血液的其他数据收集 压力，身高，体重以及行为和社会心理因素（例如饮食，体育锻炼，歧视）。 使用这些数据，她将研究个人，家庭和社区因素之间的关系 和血压。此外，她将与6个焦点小组研讨会（n = 48）的社区领导人与 创建多层次因素与HTN之间感知联系的因果结构。然后她将合成 定性数据和因果结构创建因果环图。该因果环图将作为 夏威夷原住民心血管健康的新型理论模型。具体目的是：1）估计 行为（体育活动，饮食，饮酒，烟草使用），生物学（BMI）之间的关联， 社会心理（适应，歧视），家庭（大小，成分，食物稀缺，食物的使用 援助）和社区（步行性，食物环境）的因素和血压 夏威夷人和2）通过焦点小组研讨会与社区领导人联系以创建因果循环图 描绘夏威夷土著社区心血管健康的多层次决定因素。