Examining How Psychosocial Stress Gets "Under the Skin" and Leads to Cardiovascular Disease Risk in Diverse Children: A Mixed-Methods Study

检查心理社会压力如何“深入皮肤”并导致不同儿童的心血管疾病风险：一项混合方法研究

• 批准号: 10753049
• 负责人: Jerica M Berge
• 金额: $ 1.78万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10753049
• 关键词: Accelerometer; Adolescence; Adolescent; Adult; Affect; African American; Age; American; American Psychological Association; Behavioral; Biological; Biological Factors; Biological Markers; Blood Pressure; Body Composition; Body mass index; COVID-19; Cardiovascular Diseases; Child; Child Behavior; Child Health; Child Rearing; Childhood; Cohort Studies; Data; Data Collection; Development; Diet; Dimensions; Disadvantaged; Disease; Disparity; Ecological momentary assessment; Epidemiology; Ethnic Origin; Ethnic Population; Exposure to; Family; Family Life Cycle; Field Reports; Focus Groups; Frequencies; Hair; Heart Rate; Hispanic; Household; Hydrocortisone; Immigrant; Individual; Interruption; Intervention; Journals; Lead; Life Cycle Stages; Measures; Methods; Minority Groups; Native Americans; Neighborhoods; Obesity; Parents; Pathway interactions; Phase; Politics; Process; Psychosocial Stress; Puberty; Public Health; Race; Refugees; Reporting; Research Personnel; Role; Severities; Skin; Stress; Structural Racism; Surveys; Time; United States National Institutes of Health; Weight; arterial stiffness; cardiovascular disorder risk; design; dietary; early experience; experience; feeding; follow-up; high risk; human centered design; hypothalamic-pituitary-adrenal axis; improved; indexing; innovation; middle childhood; novel; obesity in children; obesity risk; prospective; psychosocial stressors; racial disparity; racial health disparity; racial population; resilience; retention rate; risk mitigation; waist circumference

ABSTRACT Recent reports from the American Journal of Public Health and the American Psychological Association identified a critical need to examine mechanisms by which exposure to psychosocial stress in childhood increases the risk for obesity and cardiovascular disease (CVD) in adulthood. Given there is a lag in time before the impact of psychosocial stress experienced in childhood is expressed as disease in adulthood, these calls-to-action urge researchers to investigate the role of modifiable factors over the course of childhood that may mitigate risk for later obesity and CVD. The proposed mixed-methods study is uniquely designed to answer these calls-to-action by examining how stress “gets under the skin” to put children at higher risk for later obesity and CVD, and ultimately health disparities by race/ethnicity. The main objectives of this study are to: (1) comprehensively examine the relationships between multi-level psychosocial stressors (i.e., individual, dyadic, household, societal) and their dimensions (i.e., severity, frequency, timing), biological factors (e.g., hypothalamic pituitary adrenal (HPA) axis activity), and child weight and emerging CVD risk over the course of childhood and (2) identify modifiable factors at the individual, parental, and familial level to interrupt these stress pathways. The proposed study will build on and expand a prior parent R01 study (HL126171). The parent R01 study is a two-phased, mixed-methods study including a prospective epidemiological cohort study with 1307 diverse parent/child (ages 5-16) dyads (≈200 each African American, Hispanic, Native American, Immigrant/Refugee, White) and an embedded ecological momentary assessment (EMA) sub-sample with 627 parent/child dyads (≈100 per each racial/ethnic group). Data was collected at two time points (baseline, 24-month follow-up). In the proposed study, online survey data and 7-day EMA data will be continued at 48 and 72 months, allowing for a total of four waves of data collection. Children, who are now ages 9-16 will be added to both the online survey and EMA data collection, in addition to participating in three 24 hr. dietary recalls and 7-day accelerometry. New biological measures (e.g., hair cortisol, body composition, arterial stiffness) with children and parents, neighborhood factors (e.g., child opportunity and disadvantage index) using geo-spatial measures, and societal-level factors (e.g., structural racism, sociopolitical shift, COVID-19) contributing to psychosocial stressors will also be added at both time points. Human-Centered Design multi-family focus groups will also be carried out to co-create intervention targets with families. This study will provide breadth and depth in understanding the pathways between multi-level psychosocial stressors and child weight and emerging CVD across important developmental milestones (e.g., puberty) and family life cycle stages (e.g., families with young children to families with adolescents). Importantly, this study will identify modifiable factors (e.g., family adaptability/resilience) that mitigate the negative impact of multi-level psychosocial stressors on child CVD that can be targeted in interventions.

抽象的 美国公共卫生杂志和美国心理协会的最新报告 确定了检查儿童心理压力的机制的关键需求 增加了成年后肥胖和心血管疾病（CVD）的风险。鉴于时间滞后 在成年后，在儿童期经历的社会心理压力的影响之前， 呼吁行动敦促研究人员在童年期间调查可修改因素的作用 可以减轻以后目标和CVD的风险。拟议的混合方法研究的设计独特 通过检查如何“受到皮肤下的压力”使孩子处于更高的状态，以回答这些呼吁 有后来的目标和CVD的风险，以及最终因种族/种族而造成的健康差异。主要目标 这项研究的是：（1）全面检查多层次心理压力源之间的关系 （即个人，二元，家庭，社会）及其尺寸（即严重性，频率，时机），生物学 因素（例如，下丘脑垂体肾上腺（HPA）轴活动），以及儿童体重和新兴的CVD风险 童年和（2）确定个人，父母和家庭层面的可修改因素 中断这些应力途径。拟议的研究将基于和扩展先前的父母R01研究 （HL126171）。家长R01研究是一项两步的混合方法研究 1307 Divers父母/儿童（5-16岁）二元组（每个非洲裔美国人约有20007年）的流行病学队列研究， 西班牙裔，美洲原住民，移民/难民，白色）和嵌入式生态瞬时评估 （EMA）子样本有627个父/子二元组（每个种族/种族群体约100）。数据以两个收集 时间点（基线，24个月的随访）。在拟议的研究中，在线调查数据和7天EMA数据将 在48和72个月的时间里继续进行，可以总共四波数据收集。孩子，现在 除了参加三个，年龄在线调查和EMA数据收集还将添加到9-16岁 24小时。饮食召回和7天的加速度计。新的生物学措施（例如，皮质醇，身体成分， 动脉僵硬）与孩子和父母，社区因素（例如，儿童机会和灾难 索引）使用地理空间措施和社会级别的因素（例如结构性种族主义，社会政治转移， COVID-19）在两个时间点也将增加为社会心理压力源做出贡献。以人为中心 设计多户家庭焦点小组还将与家庭共同创建干预目标。这 研究将为理解多层次心理社会的途径提供广度和深度 在重要的发展里程碑中的分数和儿童体重和新兴CVD（例如， 青春期）和家庭生命周期阶段（例如，有年幼的孩子到有青少年家庭的家庭）。 重要的是，这项研究将确定可修改的因素（例如，家庭适应性/韧性）减轻 多层社会心理压力源对可以针对干预措施的儿童CVD的负面影响。