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

项目摘要 高血压导致其他慢性疾病的高发病率和死亡率，包括 心血管疾病、肥胖症、糖尿病和终末期肾病。非洲裔美国人（AAs）更有可能 与其他种族/族裔群体相比， 治疗率，不太可能控制血压。种族差异按性别持续存在-AA妇女 与白色同龄人相比，他们的高血压发病率更高，发病更早。经验 压力，包括种族和性别相关的压力，以及与压力相关的应对被认为是这些问题的根源。 差距。非裔美国妇女表现出更大的压力，这可以通过比男性更高的非稳态负荷来证明。 生命历程相对于男性和白色同行。高血压的发病率高，发病早， 年轻的AA妇女是预防的主要目标;然而， 由于对这一亚组的潜在机制了解有限，干预受到抑制。为了填补这些关键的 差距，本提案将使用顺序混合方法的方法，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 监测; 2）开发和测试压力的可行性，可接受性和初步功效 管理干预，可能会减轻慢性压力对年轻人血压水平的影响 戒酒会的女人。 这个指导职业发展奖的候选人，博士安妮卡L。海因斯是一名助理教授 弗吉尼亚联邦大学医学院健康行为与政策专业。长期职业生涯 我的目标是：1）成为一名独立的研究者，解释压力的复杂和累积效应 在健康差异的背景下，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，利用 跨学科、社会生态学方法。在此期间，海因斯博士将接受严格的说教， 研究培训，包括教学课程，体验式实验室培训和实际研究经验， 将大大提高她在干预开发和进行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与导师，顾问和 具有多层次和行为干预专业知识的合作者，循证行为医学 方法，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，先进的统计分析，健康公平和赠款发展。这些活动将为海因斯博士 有一个坚实的基础，以确保她成功过渡到一个独立的，跨学科的研究者， 有能力进行行为干预试验，为健康公平服务。

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.