Examining associations of sexual identity, life experiences, and cardiovascular disease risk in sisters

检查姐妹的性别认同、生活经历和心血管疾病风险之间的关联

• 批准号: 10449231
• 负责人: Billy A Caceres
• 金额: $ 17.17万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10449231
• 关键词: Academy; Accounting; Address; Adult; Age; Alcohol consumption; American Heart Association; Anxiety; Award; Behavior Therapy; Behavioral; Biological; Bisexual; Body mass index; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Characteristics; Chicago; Childhood; Clinical; Data Analyses; Data Reporting; Development; Diabetes Mellitus; Diet; Discrimination; Enrollment; Environment; Ethnic Origin; Exhibits; Foundations; Funding; General Population; Genetic; Glycosylated Hemoglobin; Goals; Health; Heavy Drinking; Heterosexuals; Hyperglycemia; Hypertension; Impairment; Inflammatory; Interleukin-6; Intervention; K-Series Research Career Programs; Knowledge; Lesbian; Life Experience; Link; Lipids; Longitudinal Studies; Medicine; Mentors; Mentorship; Methods; Mission; Modeling; National Health and Nutrition Examination Survey; National Heart, Lung, and Blood Institute; Not Hispanic or Latino; Obesity; Patient Self-Report; Personal Satisfaction; Physical activity; Physiological; Population; Prevention; Publishing; Race; Reporting; Research; Research Activity; Research Personnel; Research Training; Risk; Risk Factors; Running; Sampling; Science; Scientist; Sexual abuse; Siblings; Sister; Stress; Testing; Tobacco use; Training; Training Activity; Trauma; United States; United States National Institutes of Health; Woman; Women' s Health; Work; acute stress; base; binge drinking; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular effects; cardiovascular health; cardiovascular nursing; cardiovascular risk factor; career; cohort; comparison group; depressive symptoms; design; disability; disease disparity; experience; health equity promotion; high risk; innovation; interpersonal trauma; meetings; modifiable risk; physical abuse; post-traumatic symptoms; prevent; programs; protective factors; psychologic; racial diversity; sex; sexual identity; sexual minority; sexual minority women; skills; sleep quality; social epidemiology; symposium; systematic review; young adult

PROJECT SUMMARY. Despite improvements in prevention and treatment, cardiovascular disease (CVD) remains the leading cause of death and disability in women. Current evidence, primarily based on self-reported data, indicates that sexual minority women (SMW; lesbian and bisexual) demonstrate significantly higher modifiable risk factors for CVD than heterosexual women (including stress, tobacco use, alcohol use, and obesity). However, little is known about factors that link sexual minority identity with CVD risk in women, which limits development of tailored prevention efforts. Although adverse life experiences (e.g., interpersonal trauma and discrimination) are posited to contribute to CVD risk in SMW, few studies have examined the potential cardiovascular effects of adverse life experiences in this population. This Career Development Award will provide Dr. Billy Caceres with the training and research skills needed to launch an independent program of research focused on identifying and mitigating the effects of stress on the association of sexual minority identity and cardiovascular health. The overall aim of this K01 application is to use a sibling design to estimate the contribution of sexual minority identity on CVD risk in women and whether this association is impacted by adverse life experiences. The proposed research is based on the scientific premise that, by accounting for unobserved familial confounding associated with CVD risk (genetics, parental factors, and childhood environment), biological heterosexual sisters will provide a strong comparison group to study CVD risk in SMW. Supported by an interdisciplinary team of mentors, Dr. Caceres will extend the Chicago Health and Life Experiences of Women (CHLEW; R01AA13328) study, the longest running study of SMW's health, to compare CVD risk among SMW enrolled in the CHLEW study (N=65) and their biological heterosexual sisters (N=65). This proposal will examine the association of sexual minority identity with: Aim 1: psychological (depressive, anxiety, and post-traumatic stress symptoms); Aim 2: behavioral (tobacco use, heavy drinking, physical activity, diet, and sleep quality); and Aim 3: physiological (cardiometabolic [body mass index, glycosylated hemoglobin, and lipids] and inflammatory [C-reactive protein and interleukin-6]) risk factors for CVD. Through coursework, seminars, experiential training, conferences, and mentored meetings, Dr. Caceres will address prior gaps in training to develop skills in: 1) women's health research, 2) behavioral cardiovascular health, 3) social epidemiology, and 4) quantitative methods for dyadic analyses. These research and training activities will inform an R01 application that will comprehensively examine physiological mechanisms that link sexual minority identity and adverse life experiences to CVD risk in women. Findings will identify modifiable psychological, behavioral, and physiological risk factors that can serve as targets for CVD prevention efforts tailored to SMW. This work provides a unique opportunity to study risk factors for CVD, a major health problem in the U.S., in a racially diverse sample of SMW and their biological heterosexual sisters.

项目摘要。尽管预防和治疗取得了进步，但心血管疾病（CVD） 仍然是妇女死亡和残疾的主要原因。目前的证据，主要基于自我报告 数据表明，性少数女性（SMW；女同性恋和双性恋）表现出明显更高的 与异性恋女性相比，CVD 的可改变危险因素（包括压力、吸烟、饮酒和 肥胖）。然而，人们对将性少数身份与女性 CVD 风险联系起来的因素知之甚少。 限制了针对性预防工作的发展。尽管不良的生活经历（例如人际创伤） 和歧视）被认为会导致 SMW 的 CVD 风险，但很少有研究探讨了潜在的可能性 不良生活经历对该人群的心血管影响。该职业发展奖将 为比利·卡塞雷斯博士提供启动独立项目所需的培训和研究技能 研究重点是确定和减轻压力对性少数群体的影响 身份和心血管健康。该 K01 应用程序的总体目标是使用兄弟设计来估计 性少数群体身份对女性 CVD 风险的贡献以及这种关联是否受到以下因素的影响 不良的生活经历。拟议的研究基于以下科学前提： 与 CVD 风险相关的未观察到的家族混杂因素（遗传、父母因素和童年时期） 环境），生物学上的异性恋姐妹将提供一个强有力的对照组来研究CVD风险 SMW。在跨学科导师团队的支持下，卡塞雷斯博士将扩展芝加哥健康与生活 妇女经历 (CHLEW; R01AA13328) 研究是对 SMW 健康状况进行时间最长的研究，以进行比较 参加 CHLEW 研究的 SMW (N=65) 及其生物学异性恋姐妹 (N=65) 的 CVD 风险。 该提案将审查性少数群体身份与以下方面的关联： 目标 1：心理（抑郁、 焦虑和创伤后应激症状）；目标 2：行为（吸烟、酗酒、体力活动） 活动、饮食和睡眠质量）；目标 3：生理（心脏代谢 [体重指数，糖基化 血红蛋白和脂质]和炎症[C反应蛋白和白细胞介素6]）CVD的危险因素。通过 卡塞雷斯博士将在课程作业、研讨会、体验式培训、会议和指导会议上发表演讲 之前在以下方面的技能培训方面存在差距：1) 妇女健康研究，2) 心血管行为健康，3) 社会流行病学，4）二元分析的定量方法。这些研究和培训活动 将通知 R01 应用程序，该应用程序将全面检查与性相关的生理机制 少数民族身份和不良生活经历对女性心血管疾病风险的影响。调查结果将确定可修改的 可作为 CVD 预防工作目标的心理、行为和生理危险因素 专为 SMW 量身定制。这项工作为研究心血管疾病这一主要健康问题的危险因素提供了独特的机会 在美国，在 SMW 及其生物学异性恋姐妹的种族多样化样本中。