The Behavioral Determinants of Metabolic Syndrome Risk Development in Young Adults

项目摘要/摘要 只有23.3%的20岁及以上的美国年轻人被认为代谢健康，根据 缺乏所有传统代谢综合征(METS)风险因素。这种危险因素通常是无症状的和 不被发现，与其他风险因素聚集在一起，增加未来的疾病风险。因此，及早干预以预防 METS风险累积至关重要，而且针对特定人群量身定做的行为干预措施也至关重要。 因此，需要进行纵向研究，以更好地了解导致最初的METS的行为变化 青少年的风险发展(行为决定因素)和这些行为变化背后的动机因素 成年人。拟议研究的长期目标是开发一种理论上驱动的干预措施 大学生蛋氨酸代谢综合征风险发生的初步预防。总体目标是：(一) 确定预防METS风险发展的最佳行为目标和(Ii)确定 这些行为背后的动机，并开发一个理论框架，将指导干预设计。这个 这个项目的基本原理是，在METS风险开发和 针对人群的框架来解释这种变化，将使大学早期干预措施的设计成为可能 通过帮助年轻人养成积极的行为来减轻未来心血管疾病的负担 这很可能会贯穿一生。为了实现这些目标，将追求两个具体目标：1)确定 行为决定因素的蛋氨酸风险发展的年轻人；和2)探索变化的心理社会和 观察到的行为变化的环境先行因素。采用纵向观测设计，150高 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 美国各地大学的独立性。对于第一个目标，行为结果(体力活动、久坐 行为、睡眠、饮食和与风险相关的行为)将被评估，METS风险分数将使用 基准传统风险因素数据。风险评分的变化和新的心血管风险标记物(例如，主动脉 动脉僵硬)将在大学一年级返回当地社区后立即进行评估。 第二个目标将在生态框架的多个层面上通过评估以下结构来实现 感知的环境、感知的压力、健康的社会决定因素以及激励理论的各个方面 如行为自我调节和自我效能感。这种方法是创新的，因为在一个面临初始风险的人群中 METS风险因素发展或风险因素聚集，我们建议先全面、纵向 评估行为改变与METS风险之间的关系，包括传统的和新的 方法论。此外，我们建议以一种生态有效的方式来评估实际行为 从家庭环境到全国各地的校园。拟议的研究具有重要意义，因为它 将通过以下方式促进预防后续临床疾病，加强机构研究环境 增加未来获得资助的机会，并为学生研究人员提供多方面的培训体验。

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.