Cardiovascular Disparities among Bereaved Latinos and Non-Latino Whites and Factors that Facilitate Resilience: A Biobehavioral Approach

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ABSTRACT The proposed five-year plan for Dr. Luz Garcini's K01 Mentor Career Development Award will help launch her independent research career in biobehavioral health disparities and cardiovascular disease (CVD) risk. In the proposed project, Dr. Garcini aims at filling a gap in the literature by understanding how bereavement increases CVD risk, including detecting relevant ethnic disparities and identifying protective factors during this difficult life transition. The proposed training and mentoring plan will supplement Dr. Garcini's expertise in health disparities and community-based research with a foundation in CVD and psychoneuroimmunology (PNI) at premiere academic and medical institutions under the mentorship of renowned experts. The proposed research will use data from a longitudinal study among 96 recently (<2 months) bereaved adults (50% Latino, 50% Non-Latino White) with CVD risk assessments (i.e., glucocorticoid (GC) resistance and inflammation) done at baseline, 3, 6, and 12 months post enrollment. Survey measures of relevant mediators and moderators will take place at each time point, with a qualitative interview done after the last visit. The proposed project will draw on Dr. Garcini's expertise, along with a mentoring team at the forefront of biomedical science, to conduct the following aims using an interdisciplinary and culturally sensitive approach. AIM 1. To assess ethnic differences (Latinos, non-Latino Whites) in the association between grief symptoms and CVD risk (GC resistance and inflammation) among bereaved adults cross-sectionally and longitudinally. Hypothesis 1. The strength of the association between grief symptoms and CVD risk will be relatively stronger among Latinos compared to Non-Latino Whites. AIM 2. To identify contextual and cultural factors that facilitate coping with bereavement among Latinos and non-Latino Whites. AIM 3. To supplement Dr. Garcini's expertise in community-based research and health disparities with a foundation in CVD and psychoneuroimmunology (PNI) at premiere institutions and under the mentorship of renowned experts with the goal of increasing faculty diversity in the biomedical sciences. The proposed studies will offer an invaluable context to apply these concepts in a meaningful way—integrating didactics and experience, with the mentorship of an advising team of experts. The proposed research will provide novel information about mechanisms and predictors that underlie CVD risk in a vulnerable population about which little is known, while also identifying protective factors that foster resilience. The longitudinal design will provide valuable information to identify critical time points for intervention. The interdisciplinary training plan will equip Dr. Garcini with extensive knowledge of CVD and PNI skills to devote her career to the study of biobehavioral health disparities, CVD risk, and social determinants of health, which is needed to inform the development of interventions aimed at reducing disease burden.