Using a Randomized Prevention Trial to Understand the Health Benefits of Supportive Couple Relationships among Rural African American Adults

项目总结 (摘自家长格兰特AG059260) 在这项提案中，我们试图遵循346名低收入、中年非裔美国人的特征样本 最近结束了一项保护强大非洲人的随机预防试验的夫妇 美国家庭(ProSAAF)计划。所有夫妇都居住在贫困的小城镇和农村社区 格鲁吉亚是全国贫困率最高的国家之一。在这个集水区的个人在 老年多种慢性疾病(CDA)的风险增加，包括心血管疾病和糖尿病 以及CDA的风险因素，如炎症和代谢综合征。继续跟踪此样本 随着对未来五年老龄化的更彻底评估，将提供首批前瞻性研究之一 在为非洲农村设计的随机预防试验中对夫妻关系和老龄化进行了研究 美国成年人。由于观测设计容易产生残留混杂和反向误差， 目前的提案将提供一个独特的机会来检验关于增强的作用的随意假设 在促进和保护非裔美国成年人的健康方面发挥作用的夫妇 累积应激暴露。因此，该提案直接响应PA-15-042号决议，该决议鼓励 创新的、假设驱动的R01授权应用程序，可以扩展对 家庭和人际关系对中老年健康和幸福感的影响。在这篇续文中 然后，我们建议从参与ProSAAF的夫妇那里收集另外两波多水平的数据 审判。这项数据收集将涉及静脉抽血和其他生物测定，以确定 ProSAAF的参与和方案引发的夫妇功能变化将发扬光大，促进非洲 美国人的健康老龄化。心理健康和行为应对策略的评估将是 也是收藏品。我们将检验以下假设：(A)ProSAAF的参与对身体健康和 农村非裔美国成年人的心理健康；(B)ProSAAF通过哪些调解机制-- 夫妻关系功能和累积压力暴露的诱发变化对非洲农村的影响 (C)农村非裔美国人健康老龄化的复原力机制。假设 将使用个人和夫妇级别的模型进行分析，以检查演员、合作伙伴和并元级别的效果。 我们提出的设计提供了强大的理论测试和更强的指导实际应用的能力 仅使用观察性研究通常是可能的。这项研究的发现将有助于 制定健康促进战略，以促进健康老龄化，并最终缩小健康差距 在农村的非裔美国人中。

PROJECT SUMMARY (From Parent Grant AG059260) In this proposal, we seek to follow a well-characterized sample of 346 low-income, middle-age African American couples who recently concluded participation in a randomized prevention trial of the Protecting Strong African American Families (ProSAAF) program. All couples reside in impoverished small towns and communities in rural Georgia in which poverty rates are among the highest in the nation. Individuals in this catchment area are at elevated risk for multiple chronic diseases of aging (CDAs) including cardiovascular disease and diabetes as well as risk factors for CDAs such as inflammation and metabolic syndrome. Continuing to follow this sample with more thorough assessments of aging over the next five years will provide one of the first prospective studies of couple relationships and aging conducted within a randomized prevention trial designed for rural African American adults. As observational designs are prone to residual confounding and reverse directionality errors, the current proposal will provide a unique opportunity for testing casual hypotheses about the role of enhanced couple functioning in promoting and protecting the health of African American adults from the erosive effects of cumulative stress exposure. This proposal, therefore, is directly responsive to PA-15-042, which encourages innovative, hypothesis-driven R01 grant applications that can expand understanding of the role and impact of families and interpersonal relationships on health and well-being in midlife and older age. In this continuation then, we propose to collect two additional waves of multi-level data from couples who participated in the ProSAAF trial. This data collection will involve intravenous blood draws and other biometrics to determine whether ProSAAF participation and program-induced changes in couple functioning will carry forward to promote African Americans’ healthy aging. Assessments of psychological well-being and behavioral coping strategies will be collected as well. We will test hypotheses concerning: (a) ProSAAF participation on the physical health and psychological well-being of rural African American adults; (b) mediating mechanisms through which ProSAAF- induced changes in couple relationship functioning and cumulative stress exposure influence rural African Americans’ health; and (c) resilience mechanisms on healthy aging among rural African Americans. Hypotheses will be analyzed using individual- and couple-level models to examine actor, partner, and dyadic-level effects. Our proposed design provides both strong tests of theory and enhanced ability to guide practical application than typically is possible using observational research alone. Findings from this research will facilitate the development of health promotion strategies to enhance healthy aging and, ultimately, reduce health disparities among rural African Americans.