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

项目摘要 (From父母补助金AG 059260） 在这项提案中，我们试图遵循一个良好的特点样本346低收入，中年非洲裔美国人 最近参加了一项保护强壮非洲人的随机预防试验的夫妇， 美国家庭（ProSAAF）所有夫妇都居住在农村贫困的小城镇和社区， 格鲁吉亚的贫困率是全国最高的。在这个集水区的个人在 多种慢性衰老疾病（CDAs）的风险增加，包括心血管疾病和糖尿病， 以及炎症和代谢综合征等CDA的风险因素。继续追踪这个样本 随着未来五年对老龄化的更全面评估， 在一项针对非洲农村地区的随机预防试验中， 美国成年人由于观测设计容易产生残余混杂和反向方向性误差， 目前的建议将提供一个独特的机会，以测试有关增强的作用的偶然假设， 夫妇在促进和保护非裔美国人的健康免受侵蚀的影响， 累积应力暴露。因此，本提案直接响应PA-15-042，其中鼓励 创新的，假设驱动的R 01赠款申请，可以扩大的作用和影响的理解， 家庭和人际关系对中老年人健康和福祉的影响。在这个延续中 然后，我们建议从参与ProSAAF的夫妇中收集另外两波多水平数据 审判这种数据收集将涉及静脉抽血和其他生物测定，以确定是否 ProSAAF的参与和方案引起的夫妇功能变化将继续促进非洲 美国人的健康老龄化心理健康和行为应对策略的评估将 也收藏了。我们将测试以下假设：（a）ProSAAF参与身体健康， 农村非洲裔美国人成年人的心理健康;（B）调解机制，通过该机制ProSAAF- 夫妻关系功能和累积压力暴露的诱导变化影响非洲农村 美国人的健康;（c）农村非裔美国人健康老龄化的弹性机制。假设 将使用个人和夫妇水平的模型来分析，以检查演员，合作伙伴和二元水平的影响。 我们提出的设计既提供了强有力的理论测试，又增强了指导实际应用的能力， 通常是可能的，只使用观察研究。这项研究的结果将有助于 制定健康促进战略，促进健康老龄化，并最终减少健康差距 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.