The Mediating role of perceived discrimination and stress in the associations between neighborhood social environment and TV Viewing among Jackson Heart Study participants.
The Mediating role of perceived discrimination and stress in the associations between neighborhood social environment and TV Viewing among Jackson Heart Study participants.
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DOI：
10.1016/j.ssmph.2021.100760
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Powell-Wiley TM
中科院分区：
文献类型：
--
作者：
Tamura K;Orstad SL;Cromley EK;Neally SJ;Claudel SE;Andrews MR;Ceasar J;Sims M;Powell-Wiley TM
本研究的目的是检验知觉歧视和压力在知觉邻里社会环境(PNSE)和电视观看之间的中介作用。杰克逊心脏研究(JHS)是一项针对密西西比州杰克逊非裔美国人的大型前瞻性队列研究，其基线数据用于4716名参与者(平均年龄655.1岁；63.4%女性)。创建了一个二元电视观看结果：≥4小时/天与<；4小时/天。PNSE变量包括邻里暴力、问题(更高的值=更多的暴力/问题)和社会凝聚力(更高的值=更大的凝聚力)。调节因素包括感知的终身歧视、日常歧视和慢性压力(值越高，意味着歧视/压力越大)。用Bootstrap生成的95%偏差校正可信区间(BC CI)进行多变量回归，以检验对人口统计学、健康相关和心理社会因素以及人口密度的中介调节。邻里暴力、问题和社会凝聚力通过终生歧视间接与看电视有关(OR=1.03，95%BC CI=0.00，1.07；OR=0.03，95%BC CI=90.99，1.06[边际]；OR=100.98，95%BC CI=90.94，0.99)和慢性压力(OR=90.95，95%BC CI=90.90，0.99；OR=0.96，95%BC CI=0.92，0.99)；OR=1.05，95%BC CI分别为：1.01，1.10)。日常歧视与看电视没有直接或间接的联系。每个PNSE变量通过终生歧视和感受到的压力间接地与看电视有关，但与JHS参与者中的日常歧视无关。终生歧视和慢性压力的中介效应的意想不到的方向性应该在未来的研究中重复。还需要进一步的研究，以确定有效的社区努力和物理环境政策(例如，安装明亮的路灯、社区治安)，以减少不利的社区条件和心理社会因素，并减少看电视和随后的心血管疾病风险。歧视和长期压力可能会在邻里研究中起到中介作用。邻里暴力、问题和社会凝聚力与看电视有关。这些联系在一定程度上受到歧视和长期压力的影响。
The aim of this study was to test the mediating role of perceived discrimination and stress on associations between perceived neighborhood social environment (PNSE) and TV viewing. Baseline data were used for 4716 participants (mean age = 55.1 y; 63.4% female) in the Jackson Heart Study (JHS), a large prospective cohort study of African Americans in Jackson, Mississippi. One binary TV viewing outcome was created: ≥4 h/day versus <4 h/day. PNSE variables included neighborhood violence, problems (higher value = more violence/problems), and social cohesion (higher value = more cohesion). Mediators included perceived lifetime discrimination, daily discrimination, and chronic stress (higher value = greater discrimination/stress). Multivariable regression was used with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation adjusting for demographics, health-related and psychosocial factors, and population density. Neighborhood violence, problems, and social cohesion were indirectly associated with TV viewing through lifetime discrimination (OR = 1.03, 95%BC CI = 1.00, 1.07; OR = 1.03, 95%BC CI = 0.99, 1.06 [marginal]; OR = 0.98, 95%BC CI = 0.94, 0.99, respectively) and chronic stress (OR = 0.95, 95%BC CI = 0.90, 0.99; OR = 0.96, 95%BC CI = 0.92, 0.99; OR = 1.05, 95%BC CI = 1.01, 1.10, respectively). Daily discrimination was neither directly nor indirectly associated with TV viewing. Each PNSE variable was indirectly associated with TV viewing via lifetime discrimination and perceived stress, but not with daily discrimination among JHS participants. Unexpected directionality of mediating effects of lifetime discrimination and chronic stress should be replicated in future studies. Further research is also needed to pinpoint effective community efforts and physical environmental policies (e.g., installing bright street lights, community policing) to reduce adverse neighborhood conditions and psychosocial factors, and decrease TV viewing and subsequent cardiovascular disease risk. Discrimination and chronic stress may serve as mediators in neighborhood research. Neighborhood violence, problems, and social cohesion were related to TV viewing. These associations were in part mediated by discrimination and chronic stress.
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