Built environments on stroke risk and stroke disparities in a national sample

全国样本中关于中风风险和中风差异的构建环境

• 批准号: 9207809
• 负责人: NATALIE COLABIANCHI
• 金额: $ 62.49万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9207809
• 关键词: Address; Adult; African American; Age; American; American Heart Association; Area; Cardiovascular Diseases; Case Fatality Rates; Cause of Death; Characteristics; Chronic Disease; Cohort Studies; Communities; Coronary heart disease; Cost Measures; Country; Crime; Data; Data Collection; Data Set; Data Sources; Death Rate; Destinations; Development; Diabetes Mellitus; Dietary intake; Disease; Disease Outcome; Documentation; Environment; Environmental Risk Factor; Food; Future; Geography; Goals; Incidence; Individual; Institution; Intervention; Investigation; Link; Measures; Methods; Modification; Neighborhoods; Not Hispanic or Latino; Parents; Participant; Patient Self-Report; Persons; Physical activity; Physical environment; Planet Earth; Price; Protocols documentation; Race; Research; Research Personnel; Rest; Risk; Risk Factors; Role; Safety; Sampling; Secure; Social Environment; Social Network; Social support; Socioeconomic Status; Source; Southeastern United States; Stroke; Stroke prevention; United States; United States National Institutes of Health; aging population; behavioral outcome; built environment; cardiovascular risk factor; cohesion; cohort; community setting; cost effective; data sharing; disability; effective intervention; experience; geographic difference; improved; land use; member; mortality; novel; population health; public health relevance; racial difference; racial disparity; segregation; social; walkability

 DESCRIPTION (provided by applicant): Stroke is one of the leading causes of death and a top cause of serious long-term disability. A number of stroke risk factors have been established at the individual-level; however, these risk factors only partially explain stroke risk and account for only half of the racial disparities in stroke. Novel exposures of stroke risk must be identifie to improve our understanding of stroke risk and to develop effective interventions. Recently, built and social environments (BSEs) have been identified as important factors to examine to further our understanding of cardiovascular disease. However, to date no studies have examined the effect of BSEs on stroke risk. BSEs may also help to explain the large racial and geographic disparities in stroke rates although this has yet to be empirically examined nationally. The proposed study would address these gaps by utilizing a unique assembled cohort, namely the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The REGARDS cohort is a national sample of adults over age 45, with oversamples of African-American participants and persons in the stroke belt. The proposed study will expand the REGARDS study to examine the effects of BSEs on incident stroke risk and on racial and geographic disparities in stroke. These aims will be achieved by obtaining data on a broad range of BSE characteristics of the REGARDS participants' built environment (e.g., food availability, park availability, food prices, physical activity facility availability, land use, steet connectivity and neighborhood physical environment) and participants' social environment (objective crime, perceived crime, neighborhood SES, social cohesion, racial residential segregation, social support and social networks, and neighborhood social environment). The data will be obtained from a number of sources including secondary commercial and administrative sources, participant self-reports and primary audits using the Street View feature in Google Earth. Environmental data will be spatially linked to participant data of the REGARDS case-cohort study. The proposed study aims to 1) examine the extent to which BSEs contribute to incident stroke risk in the REGARDS study; and 2) determine the extent to which BSEs explain racial and geographic disparities in incident stroke. The proposed study builds on important preliminary studies and the extensive relevant experience of the investigative team, which includes prominent scholars across a number of institutions. The proposed research provides a cost-effective way to examine the importance of BSEs for stroke prevention across diverse community settings and racial groups. Identifying the BSE characteristics that are predictive of incident stroke and BSEs that contribute to racial and geographic disparities will help inform future modifications of environments to improve population health. At the end of the study period, the BSE data will be made available to others through the REGARDS data sharing protocols; thus the measures in the proposed study will be available to the greater scientific community for use in research pertaining to other disease outcomes.

 描述（由申请人提供）：中风是导致死亡的主要原因之一，也是导致严重长期残疾的首要原因。在个人层面上已经确定了许多中风危险因素，但这些危险因素只能部分解释。中风风险和账户 必须确定中风风险的新暴露，以提高我们对中风风险的了解并制定有效的干预措施，最近，建筑和社会环境（BSE）已被确定为需要进一步研究的重要因素。然而，迄今为止，还没有研究检验疯牛病对中风风险的影响，这也可能有助于解释中风发生率的巨大种族和地理差异，尽管这项研究尚未在全国范围内进行实证检验。将通过利用一个独特的组合队列来解决这些差距，即卒中地理和种族差异的原因 (REGARDS) 队列。REGARDS 队列是 45 岁以上成年人的全国样本，其中对非裔美国人参与者和人群进行了过度抽样。拟议的研究将扩大 REGARDS 研究范围，以研究疯牛病对中风发生风险以及中风种族和地理差异的影响。这些目标将通过获取广泛的数据来实现。 REGARDS 参与者的建筑环境（例如，食物供应情况、公园供应情况、食品价格、体育活动设施供应情况、土地利用、街道连通性和邻里物理环境）和参与者的社会环境（客观犯罪、感知犯罪、邻里关系）的疯牛病特征SES、社会凝聚力、种族居住隔离、社会支持和社交网络以及邻里社会环境）数据将从多个来源获得，包括次要商业和行政来源、参与者自我报告和使用街景功能的初步审计。在谷歌地球.环境数据将与 REGARDS 病例队列研究的参与者数据相关联。拟议的研究旨在 1) 检查 BSE 在 REGARDS 研究中对中风风险的影响程度；2) 确定 BSE 对中风风险的影响程度。疯牛病对中风事件的种族解释和地理差异进行了研究，该研究建立在重要的初步研究和调查团队广泛的相关经验的基础上，该研究团队包括多个机构的知名学者。研究疯牛病在不同社区环境和种族群体中预防中风的重要性，确定可预测中风事件的疯牛病特征以及导致种族和地理差异的疯牛病，将有助于为未来的环境改变提供信息，以改善人口健康。在研究期间，疯牛病数据将通过 REGARDS 数据共享协议提供给其他人；因此，拟议研究中的措施将可供更大的科学界用于与其他疾病结果相关的研究。