The Behavioral Determinants of Metabolic Syndrome Risk Development in Young Adults

项目概要/摘要 只有23.3%的20岁及以上的美国年轻人被认为是代谢健康的，根据这项研究， 不存在所有传统代谢综合征（MetS）风险因素。这些危险因素通常没有症状， 未被发现，与其他风险因素聚集在一起，增加未来的疾病风险。因此，早期干预，以防止 代谢综合征的风险累积是至关重要的，这是至关重要的，行为干预措施是针对特定人群。 因此，需要进行纵向研究，以更好地了解导致初始代谢综合征的行为变化 风险发展（行为决定因素）和这些行为变化背后的动机因素， 成年人了拟议研究的长期目标是开发一种理论驱动的干预措施， 大学生代谢综合征危险发展的根本预防。总体目标是：（一） 确定预防MetS风险发展的最佳行为目标;（ii）确定 这些行为背后的动机，并制定一个理论框架，将指导干预设计。的 该项目的基本原理是，识别MetS风险开发之前的行为， 解释这种变化的特定人群框架将使早期大学干预措施的设计成为可能。 通过帮助年轻人采取积极的行为来减少未来心血管疾病的负担 可能会伴随一生为了实现这些目标，将追求两个具体目标：1）确定 年轻人MetS风险发展的行为决定因素; 2）探索心理社会和 观察到的行为变化的环境前因。采用纵向观察设计，150高 学校的高年级学生将被观察15个月，因为他们从当地的高中过渡到行为 在美国各地的大学独立。对于第一个目标，行为结果（体力活动，久坐 行为、睡眠、饮食和风险相关行为）进行评估，MetS风险评分将使用 传统的风险因素数据。风险评分和新型心血管风险标志物（例如主动脉 动脉硬化）将在大学一年级后立即评估，一旦返回当地社区。 第二个目标将在生态框架的多个层面上解决， 作为感知环境，感知压力，健康的社会决定因素，以及动机理论的各个方面 例如行为自我调节和自我效能。这种方法是创新的，因为在有初始感染风险的人群中， MetS风险因素发展或风险因素聚类，我们提出先综合、纵向 评估行为改变与代谢综合征风险之间的关系，包括传统和新的 方法论。此外，我们建议以生态有效的方式评估实际行为， 从家庭环境到全国各地的校园。这项拟议的研究意义重大，因为它 将促进后续临床疾病的预防，加强机构研究环境， 增加未来获得赠款的机会，并为学生研究人员提供多方面的培训经验。

PROJECT SUMMARY / ABSTRACT As few as 23.3% of U.S. young adults 20 years and up are considered metabolically healthy, based on the absence of all traditional metabolic syndrome (MetS) risk factors. Such risk factors are often asymptomatic and go undetected, clustering with other risk factors to increase future disease risk. Thus, early intervention to prevent MetS risk accrual is crucial and it is critical that behavioral interventions are tailored to specific populations. Accordingly, longitudinal research is needed to better understand the behavioral changes that lead to initial MetS risk development (behavioral determinants) and the motivating factors behind these behavioral changes in young adults. The long-term goal of the proposed research is to develop a theoretically driven intervention for the primordial prevention of MetS risk development in college students. The overall objectives are to (i) identify the optimal behavioral targets for the prevention of MetS risk development and (ii) to identify the motivations behind such behaviors and develop a theoretical framework that will guide intervention design. The rationale for this project is that the identification of the behaviors that precede MetS risk development and a population-specific framework to explain such changes will enable the design of interventions in the early college years to reduce the future burden of cardiovascular disease by helping young adults to adopt positive behaviors that will likely track throughout life. To achieve these objectives, two specific aims will be pursued: 1) Identify the behavioral determinants of MetS risk development in young adults; and 2) Explore changes in psychosocial and environmental antecedents of observed behavioral change. Using a longitudinal observational design, 150 high school seniors will be observed over 15 months as they transition from local high schools to behavioral independence at colleges across the US. For the first aim, behavioral outcomes (physical activity, sedentary behavior, sleep, diet, and risk-related behaviors) will be assessed and MetS risk scores will be calculated using baseline traditional risk factor data. Change in risk scores and novel cardiovascular risk markers (e.g. aortic arterial stiffness) will be assessed immediately following year one of college, upon return to the local community. The second aim will be addressed at multiple levels of the ecological framework by assessing constructs such as the perceived environment, perceived stress, social determinants of health, and aspects of motivational theory such as behavioral self-regulation and self-efficacy. The approach is innovative as, in a population at-risk of initial MetS risk factor development or risk factor clustering, we propose the first comprehensive, longitudinal assessment of the relationship between behavior change and MetS risk, including both traditional and novel methodologies. Moreover, we propose to do so in an ecologically valid manner that assesses actual behavior change from the home environment to campuses across the country. The proposed research is significant as it will promote prevention of subsequent clinical disease, strengthen the institutional research environment by increasing future chances of grant funding, and provide multifaceted training experiences to student researchers.