The effects of pandemic-related stressors on change in CVD Risk: The protective role of universal prevention

流行病相关压力源对 CVD 风险变化的影响：普遍预防的保护作用

• 批准号: 10615346
• 负责人: MARK Ethan FEINBERG
• 金额: $ 71.58万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-02 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615346
• 关键词: Acute; Anxiety; Blood Pressure; Body mass index; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Cardiovascular Diseases; Child; Child Mental Health; Cholesterol; Climate; Communicable Diseases; Conflict (Psychology); Couples; Data; Data Collection; Data Set; Development; Disasters; Disease; Dislocations; Distal; Economics; Education; Epidemic; Face; Family; Family member; Financial Hardship; Foundations; Frequencies; Funding; Future; Gender; Gene Expression; Glycosylated hemoglobin A; Health; Hostility; Income; Inflammatory; Interleukin-6; Intervention; Investigation; Knowledge; Link; Loneliness; Mediating; Mental Depression; Mental Health; Meta-Analysis; Myocardial Ischemia; Natural Disasters; Parents; Pathway interactions; Patient Self-Report; Peripheral; Personal Satisfaction; Phase; Physiological; Positioning Attribute; Prevention; Prevention program; Process; Public Health; Randomized; Recovery; Research; Risk; Risk Factors; Risk Marker; Role; Sampling; Social Distance; Social isolation; Societies; Socioeconomic Status; Stress; Surveys; Time; Work; cardiovascular disorder risk; climate change; coping; family building; follow-up; high risk; improved; inflammatory marker; intervention effect; lonely individuals; pandemic disease; pandemic impact; physical conditioning; post-pandemic; pre-pandemic; preventive intervention; programs; promote resilience; protective factors; randomized trial; resilience; social; stressor; stroke risk; universal prevention

ABSTRACT Although we are not yet in a position to estimate the total collateral damage to health and society due to the COVID-19 pandemic, widespread increases in stress, financial strain, depression/anxiety, family conflict, and social isolation during the pandemic may each have large and cumulative long-term impacts on physical health, particular via cardiovascular disease (CVD). For example, given that evidence from a large recent meta-analysis indicates that risk for stroke and ischemic heart disease is about 30% higher in lonely and socially isolated people, the CVD-related “consequences of social distancing may be profound”. Pandemic- related stressors, such as financial strain and social distancing, may be particularly difficult for families with young children. In this context, the proposed project is uniquely positioned to examine important theoretical and practical public health questions that will inform future efforts to minimize the negative collateral health impacts of infectious disease epidemics as well as other crises: To what extent did the COVID-19 pandemic increase CVD risk among parents and children? Which of the multiple stressors associated with such a crisis ̶ e.g., financial, mental health, social isolation, family conflict ̶were most strongly linked to increases in CVD risk among parents and children? Can universal prevention programming enhance parent and child resilience in order to protect against crisis-related stressors and mitigate crisis-related increases in CVD risk? Aim 1: To examine the magnitude of change in CVD risk (a) from pre-pandemic to a time point near the anticipated end of the pandemic (“post-pandemic”) and (b) from the “post-pandemic” time point to 18 months later. We will assess whether pandemic-period financial strain, mental health problems, and family conflict predict CVD risk changes. Aim 2. To examine whether random assignment to effective family prevention is associated with (a) a reduction in the hypothesized increase in CVD risk across the pandemic; (b) greater “recovery” in CVD health indicators over an 18 month period during which we expect most pandemic-related restrictions will have been eased; and (c) reduced associations between pandemic-related stressors and change in CVD risk (moderation). Aim 3: To examine whether gender or pre-pandemic indicators of socioeconomic status (income, education) moderate the associations examined in Aims 1 and 2. Impact. This project will result in new practical and theoretical knowledge that is important as we face increased frequency of infectious disease epidemics and climate change-related environmental disasters. Research that increases understanding of the stress-related processes within families that impact CVD health risk will inform future intervention approaches to reduce CVD risk during periods of family crisis, social- economic dislocation, and natural disasters. Understanding the factors that relate to risk and resilience will allow program developers to more precisely target salient mechanisms as well as families at highest risk.

抽象的 尽管我们还没有能够估计健康和社会的健康和社会。 COVID-19-大流行，压力，财务压力，抑郁/焦虑，家庭冲突的广泛增加，以及 大流行期间的社会隔离可能会对身体产生巨大的累积长期影响 健康，特别是通过心血管疾病（CVD）。 荟萃分析表明，孤独和缺血性心脏病的风险约为30％的孤独感和 社会上孤立的人，与CVD相关的“贫困距离可能是深刻的”。 相关压力源，例如财务压力和社会疏远，可能是困难的家庭 在这种情况下，幼儿是独特的，可以检查重要的理论 以及实用的公共卫生问题，这些问题将为未来的努力提供最大程度地减少负面抵押健康的努力 感染疾病流行病以及其他纵横升组的影响：互联19大流行的程度在多大程度上 增加父母和儿童的CVD风险？ 例如，财务，心理健康，社会隔离，家庭冲突 - 与CVD的增加最密切相关 父母和孩子的风险可以增强父母和儿童的弹性 为了防止与危机相关的压力源并减轻与危机相关的CVD风险增加？ 目的1：检查CVD风险变化的大幅度（a）从大流行前到附近的时间点 从“大流行后”时间点到18个月的大流行（“大流行”）和（b）的预期末端 以后。 预测CVD风险变化。 与（a）降低了大流行中CVD风险的降低； CVD健康指标的“恢复”在18个月内，我们期望与大流行有关 限制将被放松 更改CVD风险（适度）。 社会经济地位（收入，教育）调节目标1和2中检查的协会。 影响这个项目将在我们面对的新的实用和理论知识中获得 感染性疾病流行病和气候变化相关的环境灾难的自由度增加。 研究增加了与压力相关的过程效果，从而影响CVD健康 风险将为未来的INTORACHES提供信息，以降低家庭危机期间CVD风险 经济错位和自然灾害。 允许计划开发人员更精确地针对机制以及最高风险的家庭。