Reducing Cardiovascular Risk in Perimenopausal Latinas: Pilot Study of a Multi-Component Intervention

降低围绝经期拉丁裔的心血管风险：多成分干预的初步研究

• 批准号: 10203810
• 负责人: Yamnia I Cortes
• 金额: $ 13.27万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-26 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10203810
• 关键词: Address; Age; Award; Awareness; Behavior Therapy; Biological; Biological Factors; Biological Markers; Blood Glucose; Blood Pressure; Cardiovascular Diseases; Cause of Death; Church; Clinical Trials Design; Communities; Community Health Aides; Control Groups; Coping Skills; Data; Development; Discrimination; Education; Enrollment; Environment; Environmental Risk Factor; Evaluation; Event; Face; Goals; Health; Health Food; Health behavior; Hispanics; Inflammatory; Institutes; Interpersonal Violence; Intervention; Intervention Studies; Interview; Investigation; Knowledge; Knowledge acquisition; Latina; Latino; Lead; Leadership; Limited English Proficiency; Lipids; Maintenance; Measurement; Measures; Menstruation; Mentorship; Neurosecretory Systems; Not Hispanic or Latino; Obesity; Outcome; Outcome Measure; Participant; Pathway interactions; Patient Recruitments; Perimenopause; Phase; Physical activity; Pilot Projects; Postmenopause; Poverty; Procedures; Protocols documentation; Public Health; Publications; Randomized; Research; Research Personnel; Risk; Risk Factors; Scientist; Self Efficacy; Self Management; Sleep; Social Discrimination; Social isolation; Stress; Stress and Coping; Symptoms; Targeted Research; Testing; Time; Training; Treatment Efficacy; Underserved Population; United States; Vasomotor; Visit; Waiting Lists; Woman; Women' s Health; Work; arterial stiffness; behavior influence; built environment; burden of illness; cardiovascular disorder epidemiology; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career development; clinical trial analysis; community engaged research; community engagement; comparative efficacy; coping; design; dietary guidelines; efficacy evaluation; ethnic minority population; evidence base; follow-up; group intervention; health disparity; improved; insight; low socioeconomic status; minority health; multi-component intervention; nutrition; preventive intervention; primary outcome; programs; recruit; retention rate; satisfaction; secondary outcome; skill acquisition; skills; skills training; social culture; stress management; therapy design

PROJECT SUMMARY / ABSTRACT Cardiovascular disease (CVD) remains the leading cause of death among women. Risk of CVD increases substantially during perimenopause, the critical window of 6-8 years before a woman’s final menstrual period. Increasing evidence suggests that Latinas have a significantly worse CVD risk factor profile than non-Hispanic women, which can be attributed to multiple sociocultural and environmental factors (e.g., lower socioeconomic position, discrimination, stress). These factors are related to CVD through their influence on health behaviors, as well as potential mechanisms involving inflammatory and neuroendocrine pathways. Although behavioral intervention research targeting CVD risk during perimenopause emerged over the past decade, no studies were designed to intervene on behavioral influences to decrease biological CVD risk among perimenopausal Latinas. Using the National Institute of Minority Health and Health Disparities (NIMHD) Framework, we will address the sociocultural and built environments and intervene on behavioral influences to decrease biologic CVD risk among perimenopausal Latinas. The aim of this investigation is to examine feasibility and initial efficacy of a behavioral intervention led by community health workers to a) decrease the primary outcomes of biologic CVD risk factors (blood pressure [BP], arterial stiffness, lipids, blood glucose); b) improve secondary outcomes (health behaviors: nutrition, physical activity, sleep, coping strategies) and other biological factors (adiposity, inflammatory and stress biomarkers, vasomotor symptoms) from baseline to 6- and 12-month follow-up. We will recruit participants from two community groups: one group will be randomly assigned to complete the intervention; the other will be a wait-list control. This intervention has 3 phases: 12 weekly sessions (Phase I: education, physical activity, stress management, coping skills training) followed by 3 monthly sessions of continued support (Phase II); and finally 6 months of skill maintenance on their own (Phase III). The long-term goal of this award is to develop Dr. Cortés’ independence as an investigator, leading a program of research dedicated to improving women’s cardiovascular health, and to implement interventions for prevention and self-management of CVD in perimenopausal women, particularly Latinas. The proposed K23 will support her development through mentorship and training in: 1) community-engaged research; 2) clinical trial design, implementation, and evaluation; 3) the effect of behavioral interventions on biologic outcomes; and 4) professional development skills in leadership, publication, and grantsmanship. To accomplish her research aims and training goals, Dr. Cortés has assembled an interdisciplinary team of scientists with expertise in community engagement, intervention design, clinical trial analysis, sociocultural and biological measures, and career development mentorship. This research holds potential to accelerate greatly the acquisition of knowledge related to CVD risk among perimenopausal Latinas, and the impact of behavioral interventions to reduce CVD risk in this underserved population.

项目概要/摘要 心血管疾病（CVD）仍然是女性死亡的主要原因。 CVD 风险增加 大部分发生在围绝经期，即女性最后一次月经前 6-8 年的关键窗口期。 越来越多的证据表明，拉丁裔的 CVD 危险因素明显比非西班牙裔更差 女性，这可归因于多种社会文化和环境因素（例如较低的社会经济地位） 地位、歧视、压力）。这些因素通过影响健康行为而与 CVD 相关， 以及涉及炎症和神经内分泌途径的潜在机制。虽然行为上 针对围绝经期期间 CVD 风险的干预研究出现在过去十年中，但没有研究 旨在干预行为影响，以降低围绝经期妇女的生物心血管疾病风险 拉丁裔。利用国家少数民族健康和健康差异研究所 (NIMHD) 框架，我们将 解决社会文化和建筑环境问题并干预行为影响以减少生物 围绝经期拉丁裔的 CVD 风险。本次调查的目的是检验可行性和初步 由社区卫生工作者主导的行为干预的功效 a) 减少主要结果 生物性CVD危险因素（血压[BP]、动脉僵硬度、血脂、血糖）； b) 改善中学 结果（健康行为：营养、体力活动、睡眠、应对策略）和其他生物因素 （肥胖、炎症和应激生物标志物、血管舒缩症状）从基线到 6 个月和 12 个月 后续行动。我们将从两个社区小组招募参与者：一组将被随机分配到 完成干预；另一个将是等待名单控制。此干预分为 3 个阶段：每周 12 次 课程（第一阶段：教育、体育活动、压力管理、应对技能培训），然后是 3 次 每月持续支持会议（第二阶段）；最后靠自己进行6个月的技能维护 （第三阶段）。该奖项的长期目标是培养 Cortés 博士作为研究者的独立性，领导 致力于改善女性心血管健康并实施干预措施的研究计划 用于围绝经期女性（尤其是拉丁裔）CVD 的预防和自我管理。拟议的 K23 将通过以下方面的指导和培训支持她的发展：1) 社区参与研究； 2） 临床试验设计、实施和评价； 3）行为干预对生物的影响 结果； 4) 领导力、出版和资助方面的专业发展技能。到 为了实现她的研究目标和培训目标，科尔特斯博士组建了一个跨学科团队 在社区参与、干预设计、临床试验分析、社会文化和 生物测量和职业发展指导。这项研究有可能大大加速 获得与围绝经期拉丁裔 CVD 风险相关的知识，以及行为的影响 旨在降低这一服务不足人群的 CVD 风险的干预措施。