An Interpersonal Relationships Intervention for Improving Cardiovascular Health in Youth

改善青少年心血管健康的人际关系干预

基本信息

批准号：
10617462
负责人：
EDITH CHEN
金额：
$ 5.93万
依托单位：
NORTHWESTERN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10617462
关键词：
Adult Affect Age Atherosclerosis Attention Behavioral Biological Blood Glucose Blood Pressure Body mass index Cardiovascular Diseases Cardiovascular system Chicago Child Childhood Cholesterol Chronic Disease Climacteric Cognitive Control Groups Development Disadvantaged Disease Disease Outcome Emotional Ethnic Origin Fostering Foundations Glucose Guidelines Health Health Benefit Health behavior High School Student Individual Inflammation Inflammatory Interpersonal Relations Intervention Intervention Studies Lead Learning Life Life Style Link Lipids Low income Measures Mediating Mediator of activation protein Mentors Minority Minority Groups Modeling National Heart, Lung, and Blood Institute Neurosecretory Systems Obesity Observational Study Outcome Pathway interactions Physiological Population Populations at Risk Prevention approach Primary Prevention Process Psychophysiology Race Randomized Randomized Controlled Trials Reduce health disparities Research Risk Schools Social support Societies Socioeconomic Status Stress Students System Testing Time Underrepresented Minority United States National Institutes of Health Ursidae Family Work Youth base behavioral response burden of illness cardiovascular health cardiovascular risk factor clinical predictors diet and exercise elementary school evidence based guidelines experience experimental study fasting glucose health disparity improved indexing insulin sensitivity intervention participants low socioeconomic status lower income families minority children mortality novel novel strategies peer physical conditioning post intervention primary outcome programs psychosocial public health relevance response scaffold skills social attachment social relationships socioeconomic disparity stress management stressor student mentoring success university student volunteer

项目摘要

PROJECT SUMMARY Disparities in cardiovascular (CV) diseases by socioeconomic status (SES) and race/ethnicity are pronounced in our society, and the processes that lead to these disparities begin in childhood. Previous intervention efforts have targeted individual lifestyle changes in health behaviors, but with limited success in low SES, minority youth. We propose a novel intervention to reduce CV risk in low SES, minority children (under 21 by NIH guidelines) that focuses on social relationships – specifically mentoring – as a way to create bi-directional benefits for CV health in youth. The rationale for this intervention is based both on work showing that receiving social support has benefits for physical health, and on work demonstrating that helping others is associated with better physical health. In this proposed intervention study, college students will serve as mentors to elementary school students (8th graders). 250 college students and 250 Chicago Public School 8th graders will be randomized to either serve as a mentor/mentee or to be in a control group. Students will participate in a weekly mentoring intervention throughout one school year. Assessments will occur at 3 time points during the school year. All mentors and mentees will come from low-income families and underrepresented minority groups, thus allowing us to focus on improving CV health in an at-risk population that experiences a disproportionate share of the CV burden in the U.S. The first aim of the project is to investigate whether mentors can reduce CV risk (obesity; blood pressure; cholesterol; blood glucose) in low-income, minority youth mentees relative to a control group of 8th graders. The second aim is to investigate whether serving as a mentor can reduce CV risk in the college student mentors compared to a control group of college students. The third aim is to understand how mentoring influences the intervention targets of psychosocial, health behavior, and biological variables, and whether these variables mediate the impact of mentoring on CV health. Drawing from the stress buffering model of social support, we propose that mentoring fosters the development of strong social relationships that can scaffold behavioral changes and hence mitigate the effects that stress has on inflammation and CV health via 2 pathways: psychophysiological and health behaviors. In the psychophysiological pathway, mentoring creates more adaptive cognitive, emotional, and behavioral responses to life stressors, which in turn mitigate responses of the sympathetic and neuroendocrine systems to stress. Over time, this reduces inflammation and improves CV health. In the health behaviors pathway, the scaffolding from mentoring relationships mitigates the associations of stress with detrimental health behaviors that in turn are linked to both inflammation and CV health. Through this study, we take a social relationships- oriented primary prevention approach to reducing health disparities by targeting CV risk factors that emerge early in life and that predict clinical CV disease outcomes into adulthood and by focusing on low-income, minority mentors and mentees who represent an at-risk, underserved, and disadvantaged group of youth.

项目摘要通过社会经济地位（SES）和种族/民族的心血管疾病差异（CV）疾病的差异。在我们的社会中，以及导致这些差异的过程始于童年。以前的干预工作针对健康行为的个人生活方式改变，但在低SES中成功有限，少数青年。我们提出了一种新的干预措施，以降低低SES，少数儿童的简历风险（NIH以下21岁以下指南）专注于社会关系（特别是指导），以创建双向青年简历健康的好处。此干预的基本原理既基于表明接受的工作社会支持对身体健康有好处，并在工作中表明帮助他人有联系身体健康更好。在这项拟议的干预研究中，大学生将作为导师小学生（八年级学生）。 250名大学生和250名芝加哥公立学校八年级学生将被随机分配为心理/受训者或成为对照组。学生将参加整个学年的每周指导干预。评估将在3个时间点进行学年。所有导师和梅内特都将来自低收入家庭和代表性不足的少数民族小组，因此使我们能够专注于改善经历的高危人群中的简历健康在美国，简历伯恩的比例不成比例的份额导师可以降低低收入，少数青年的简历风险（肥胖；血压；胆固醇；血糖） Menees相对于8年级的对照组。第二个目的是调查是否充当与对照组的大学生相比，导师可以降低大学生导师的简历风险。第三个目的是了解心理化如何影响心理社会，健康的干预目标行为和生物变量，以及这些变量是否介导心理对简历健康的影响。从社会支持的压力缓冲模型中汲取灵感，我们建议指导促进发展具有牢固的社会关系，可以踩踏行为变化，从而减轻压力的影响通过2种途径具有炎症和简历健康：心理生理和健康行为。在心理生理途径，脑力学创造了更多的自适应认知，情感和行为对生活压力源的反应，这反过来减轻了同情和神经内分泌系统对压力。随着时间的流逝，这会减少感染并改善简历健康。在健康行为途径中来自心理关系的脚手架减轻了压力与有害健康行为的关联反过来，这与炎症和简历健康有关。通过这项研究，我们建立了社会关系 - 定向初级预防方法通过针对出现的简历风险因素来降低健康差异在生命的早期，这可以预测成年后的临床简历疾病结局，并专注于低收入，少数派导师和导师，他们代表着一群危险，服务不足和处于弱势群体的年轻人。