Developing Novel Intervention Approaches to Mitigate Cardiovascular Risk among Young African-American Women

开发新的干预方法来降低年轻非洲裔美国女性的心血管风险

• 批准号: 10215733
• 负责人: Anika Latrice Hines
• 金额: $ 16.41万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10215733
• 关键词: Academic Medical Centers; Address; African American; Aftercare; Age; Award; Behavior; Behavior Therapy; Behavioral Medicine; Blood; Blood Pressure; Cardiovascular Diseases; Chronic; Chronic Disease; Chronic stress; Clinical; Complex; Coupled; Data; Development; Devices; Diabetes Mellitus; Discrimination; Ecological momentary assessment; Electrocardiogram; Emotions; End stage renal failure; Endocrine; Ensure; Environment; Ethnic group; Evidence based intervention; Exposure to; Foundations; Funding; Gender; Goals; Grant; Health; Health Policy; Health Services; Health Services Research; Health behavior; Hour; Hypertension; Incidence; Individual; Inflammatory Response; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Life; Life Cycle Stages; Link; Literature; Longevity; Measures; Mentors; Methods; Monitor; Moods; Morbidity - disease rate; Obesity; Outcome Assessment; Participant; Pathway interactions; Physiologic Monitoring; Physiological; Plant Roots; Policies; Population; Preparation; Prevention; Primary Prevention; Protocols documentation; Qualitative Methods; Race; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Research Training; Risk; Risk Factors; Sample Size; Secondary Prevention; Solid; Statistical Data Interpretation; Stress; Subgroup; Surveys; Technology; Testing; Time; Training; Universities; Virginia; Vulnerable Populations; Woman; Work; allostatic load; arm; behavior change; behavioral clinical trial; behavioral response; biological adaptation to stress; blood pressure regulation; cardiovascular disorder risk; cardiovascular risk factor; career; career development; community engagement; coping; coping mechanism; design; early onset; ethnic minority population; evidence base; experience; feasibility testing; health disparity; health equity; heart rate variability; implementation outcomes; in vivo; innovation; laboratory experience; male; medical schools; men; mobile application; mortality; novel; pilot trial; professor; psychologic; racial and ethnic; racial disparity; recruit; relating to nervous system; response; satisfaction; sex; skills; social epidemiology; social stress; stress management; stress reduction; stressor; therapy development

PROJECT SUMMARY Hypertension contributes to high rates of morbidity and mortality of other chronic conditions, including cardiovascular disease, obesity, diabetes, and end stage renal disease. African Americans (AAs) are more likely to develop high blood pressure and at a younger age compared to other racial/ethnic groups, and despite higher treatment rates, are less likely to have blood pressure under control. Racial disparities persist by sex—AA women have higher incidence of hypertension and earlier onset compared to their white counterparts. Experiences of stress, including race- and gender-related stress, and stress-related coping are thought to be at the root of these disparities. African American women demonstrate greater stress as evidenced by higher allostatic load over the life course relative to male and white counterparts. Higher incidence and earlier onset of hypertension make younger AA women a prime target for prevention; however, the development of effective prevention-focused interventions is inhibited by limited understanding of underlying mechanisms in this subgroup. To fill these critical gaps, this proposal will use a sequential mixed methods approach, including the following: 1) quantifying stress responses in vivo using a 14-day ecological momentary assessment (EMA) protocol with 24-hour physiological monitoring; and 2) developing and testing the feasibility, acceptability and preliminary efficacy of a stress management intervention that may mitigate the effects of the chronic stress on blood pressure levels in young AA women. The candidate for this mentored Career Development Award, Dr. Anika L. Hines, is an Assistant Professor in Health Behavior and Policy at the Virginia Commonwealth University School of Medicine. Her long term career goal is to: 1) become an independent investigator who explicates the complex and cumulative effects of stress in the lived experiences of racial/ethnic minorities within the context of health disparities; and 2) design and implement innovative, evidence-based interventions and policies to address these stressors using an interdisciplinary, socioecological approach. During this award, Dr. Hines will undergo rigorous didactic and research training, including an didactic courses, experiential lab training, and practical research experience, that will substantially build her skills in intervention development and the conduct of randomized controlled trials for behavioral interventions. These career development activities will be conducted within the rich training environment of Virginia's largest academic medical center with direct guidance from mentors, advisors, and collaborators with expertise in multi-level and behavioral interventions, evidence-based behavioral medicine approaches, race-related stress, qualitative methods, physiological pathways linking stress and cardiovascular risks, advanced statistical analyses, health equity, and grant development. These activities will provide Dr. Hines with a solid foundation to ensure her successful transition to an independent, interdisciplinary investigator who is well equipped to conduct behavioral intervention trials in service of health equity.

项目概要 高血压导致其他慢性病的高发病率和死亡率，包括 心血管疾病、肥胖、糖尿病和终末期肾病。非裔美国人 (AA) 更有可能 与其他种族/族裔群体相比，患高血压的年龄更小，尽管 治疗率降低，血压得到控制的可能性较小。性别差异依然存在——AA 女性 与白人相比，他们的高血压发病率更高且发病更早。的经历 压力，包括与种族和性别相关的压力以及与压力相关的应对方式被认为是这些问题的根源 差异。非洲裔美国女性表现出更大的压力，这一点可以通过比女性更高的调节负荷来证明。 相对于男性和白人的生命历程。高血压发病率较高、发病较早 年轻的 AA 女性是预防的主要目标；然而，制定有效的、以预防为重点的 由于对该亚组的潜在机制了解有限，干预措施受到限制。为了填补这些关键 为了弥补差距，本提案将使用顺序混合方法，包括以下内容：1）量化压力 使用 14 天生态瞬时评估 (EMA) 方案和 24 小时生理反应进行体内反应 监控； 2) 制定并测试压力的可行性、可接受性和初步功效 管理干预可以减轻慢性压力对年轻人血压水平的影响 AA 女性。 该指导职业发展奖的候选人 Anika L. Hines 博士是助理教授 弗吉尼亚联邦大学医学院健康行为与政策专业。她的长期职业生涯 目标是：1）成为一名独立调查员，解释压力的复杂和累积影响 在健康差异背景下少数种族/族裔的生活经历； 2）设计和 实施创新的、基于证据的干预措施和政策，以解决这些压力源 跨学科的社会生态学方法。在获奖期间，海因斯博士将接受严格的教学和 研究培训，包括教学课程、体验式实验室培训和实践研究经验， 将大大提高她在干预措施开发和随机对照试验方面的技能 行为干预。这些职业发展活动将在丰富的培训内进行 弗吉尼亚州最大的学术医疗中心的环境，有导师、顾问和专家的直接指导 具有多层次行为干预、循证行为医学专业知识的合作者 方法、与种族相关的压力、定性方法、连接压力和心血管的生理途径 风险、高级统计分析、健康公平和赠款开发。这些活动将为海因斯博士提供 具有坚实的基础，可确保她成功过渡为独立的跨学科调查员 完全有能力进行行为干预试验，以服务于健康公平。