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 尽管我们还无法估计由于新冠肺炎疫情对健康和社会造成的总体附带损害 COVID-19 大流行、压力、财务紧张、抑郁/焦虑、家庭冲突和 大流行期间的社会隔离可能会对身体产生巨大且累积的长期影响 健康，特别是心血管疾病（CVD），例如，鉴于最近的大量证据。 荟萃分析表明，孤独和孤独的人患中风和缺血性心脏病的风险大约高出 30%。 对于社会孤立的人来说，与心血管疾病相关的“社会疏远的后果可能是深远的”。 相关的压力源，例如经济压力和社交距离，对于患有此类疾病的家庭来说可能尤其困难 在这种背景下，拟议的项目具有独特的定位来研究重要的理论。 以及实际的公共卫生问题，这些问题将为未来最大限度地减少负面附带健康的努力提供信息 传染病流行以及其他危机的影响：COVID-19 大流行在多大程度上影响了 与此类危机相关的多重压力因素有哪些？ 例如，财务、心理健康、社会孤立、家庭冲突——与心血管疾病的增加密切相关 家长和儿童面临的风险？ 全民预防规划能否增强家长和儿童的抵御能力？ 为了防范与危机相关的压力源并减轻与危机相关的 CVD 风险增加？ 目标 1：检查 CVD 风险 (a) 从大流行前到接近大流行的时间点的变化幅度 预期大流行结束（“大流行后”）和 (b) 从“大流行后”时间点至 18 个月 稍后我们将评估大流行期间是否存在财务压力、心理健康问题和家庭冲突。 目标 2. 检验有效家庭预防的随机分配是否有效。 与 (a) 整个大流行期间 CVD 风险增加的减少有关； CVD 健康指标在 18 个月内“恢复”，我们预计在此期间大多数与大流行相关的指标 限制将得到放松；(c) 减少与大流行相关的压力源和 目标 3：检查性别或大流行前指标是否会影响 CVD 风险的变化（适度）。 失业状况（收入、教育）调节目标 1 和 2 中考察的关联。 该项目将带来新的实践和理论知识，这对我们来说非常重要。 传染病流行和与气候变化有关的环境灾害的频率增加。 研究旨在增进对影响 CVD 健康的家庭内压力相关过程的了解 风险将为未来的干预方法提供信息，以减少家庭危机、社会危机期间的CVD风险 了解与风险和复原力相关的因素。 使程序开发人员能够更准确地针对显着机制以及风险最高的家庭。