Evaluating Standing as a Health Behavior to Promote Cardiovascular Risk Reduction in African Americans

评估站立作为一种健康行为，以促进非洲裔美国人降低心血管风险

• 批准号: 10097210
• 负责人: Keith M Diaz
• 金额: $ 60.46万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10097210
• 关键词: Accelerometer; Address; Adult; Advocate; African American; American; Ancillary Study; Ankle; Back; Behavior; Blood Pressure; Blood Vessels; Cholesterol; Cognitive; Cohort Studies; Communities; Detection; Developed Countries; Employee; Enrollment; Epidemic; Evaluation; Exhibits; Foundations; Future; Glucose; Goals; Gold; Guidelines; Health; Health Benefit; Health Hazards; Health Policy; Health behavior; Health trends; Home; Individual; Infrastructure; Intervention; Jackson Heart Study; Length; Lower Extremity; Measurement; Measures; Methods; Modification; Musculoskeletal; Musculoskeletal Pain; Observational Study; Outcome; Participant; Pattern; Perception; Peripheral Vascular Diseases; Physical activity; Population Group; Posture; Procedures; Prospective Studies; Protocols documentation; Public Health; Questionnaires; Research; Research Priority; Risk; Risk Factors; Risk Reduction; Schedule; Schools; Smoking; Strenuous Exercise; Stroke Belt; Techniques; Time; Triglycerides; Upper Extremity; Visit; Work; Workplace; base; cardiometabolic risk; cardiometabolism; cardiovascular disorder risk; cardiovascular risk factor; cost; cost effective; demographics; evidence base; follow-up; high risk; high risk population; improved; indexing; interest; mortality; mortality risk; novel; pain symptom; physical conditioning; prospective; sedentary; sedentary lifestyle; social; standard measure; success; waist circumference

US adults are sedentary for ~11-12 h/day - which greatly increases cardiovascular disease (CVD) and mortality risk. The Physical Activity Guidelines for Americans have expanded beyond promoting moderate- vigorous physical activity and now also advocate for reductions in sedentary time. Accordingly, there is strong interest in elucidating simple, cost-effective methods to reduce sedentary time. The popular press and corporations seeking to capitalize on health trends have perpetuated the notion that simply standing in place is a healthful alternative to sitting. Consequently, standing and sit-to-stand desks are the fastest growing employee benefit in US workplaces. However, there is a paucity of evidence documenting the health benefits of standing. As such, despite public perception that standing is a healthful alternative, it remains absent from physical activity guidelines, with concerns raised that standing could be more harmful then sitting. The goal of the proposed study is to comprehensively evaluate purported benefits (cardiometabolic) and risks (vascular damage to lower limbs, musculoskeletal pain) that may be incurred with standing and its accrual pattern in the highest risk group in the US - African Americans living in the stroke belt. The prospective association between objectively-measured standing time and the 2-year change in a composite CVD risk score (comprising glucose, triglycerides, cholesterol, blood pressure, waist circumference) will be evaluated (Aim 1). Multiple novel standing pattern variables (e.g. distribution, length, and regularity of standing bouts) will be investigated to identify which aspects of standing are most associated with the 2-year change in CVD risk score (Aim 2). State of the art analytic techniques will be used to evaluate if reallocating time from sedentary to standing would yield CVD risk score reductions (Secondary Aim). Prospective associations between standing time/patterns and the 2-year change in the ankle-brachial index (ABI, an index of peripheral vascular disease) and musculoskeletal pain symptoms, and the cross-sectional/prospective predictors of standing will also be examined (Exploratory Aims). To address our study aims, we will leverage the infrastructure of the Jackson Heart Study (JHS), an exclusively African American cohort study. A fourth JHS exam is scheduled to be conducted in 2020-2022 and will include assessment of CVD risk factors. For this ancillary study, we propose to add a 7-day accelerometer protocol (with posture detection), ABI assessment, and questionnaires to this exam for 1,250 participants. We furthermore propose a follow-up visit 2 years later to re-assess these measures and CVD risk factors. Findings will (1) inform probable cause and effect associations with respect to standing and health outcomes, (2) identify optimal patterns of standing that should be promoted, (3) establish endpoints for future trials promoting standing, and (4) identify predictors of standing that can serve as intervention targets. We view this project as a critical next step that will provide foundational evidence important for success of future trials and ultimately public health efforts targeting sedentary behavior in African Americans and other population groups.

美国成年人每天久坐约 11-12 小时 - 这大大增加了心血管疾病 (CVD) 和 死亡风险。 《美国人身体活动指南》的范围已经超出了促进适度运动的范围 剧烈的身体活动，现在还提倡减少久坐时间。据此，有很强的 有兴趣阐明简单、经济有效的方法来减少久坐时间。大众媒体和 寻求利用健康趋势的公司一直延续这样的观念：只要坚守岗位就可以 坐姿的健康替代方案。因此，站立式和坐立式办公桌是增长最快的 美国工作场所的员工福利。然而，缺乏证据证明其对健康的益处 的站立。因此，尽管公众认为站立是一种健康的选择，但它仍然缺席 身体活动指南，有人担心站立可能比坐着更有害。目标是 拟议的研究是为了全面评估所谓的益处（心脏代谢）和风险（血管 站立可能引起的下肢损伤、肌肉骨骼疼痛）及其累积模式 美国最高风险群体——生活在中风带的非裔美国人。之间的预期关联 客观测量的站立时间和复合 CVD 风险评分（包括葡萄糖、 甘油三酯、胆固醇、血压、腰围）将被评估（目标 1）。多本小说 将调查站立模式变量（例如站立回合的分布、长度和规律性） 确定站立的哪些方面与 CVD 风险评分的 2 年变化最相关（目标 2）。状态 将使用最先进的分析技术来评估从久坐到站立的重新分配时间是否会产生效果 CVD 风险评分降低（次要目标）。站立时间/模式与 踝臂指数（ABI，周围血管疾病指数）和肌肉骨骼的 2 年变化 疼痛症状以及站立的横截面/前瞻性预测因素也将被检查（探索性 目标）。为了实现我们的研究目标，我们将利用杰克逊心脏研究 (JHS) 的基础设施，这是一项 专门针对非裔美国人的队列研究。第四次 JHS 考试计划于 2020-2022 年进行 将包括CVD风险因素的评估。对于这项辅助研究，我们建议添加一个 7 天的加速度计 协议（带有姿势检测）、ABI 评估以及针对 1,250 名参与者的此次考试的调查问卷。我们 此外，建议 2 年后进行随访，重新评估这些措施和 CVD 风险因素。发现 将 (1) 告知与地位和健康结果相关的可能因果关系，(2) 确定 应推广的最佳站立模式，(3) 为未来的试验建立终点，以促进 站立，(4) 确定可作为干预目标的站立预测因素。我们将此项目视为 关键的下一步将为未来试验的成功提供重要的基础证据，并最终 针对非裔美国人和其他人群久坐行为的公共卫生工作。