Systems Science Informed Multilevel Theoretical Model of Cardiovascular Health in Native Hawaiians

此补充申请的目的是支持克莱尔博士的研究和职业发展 汤森英在建立自己作为一个独立的调查参与社区和使用系统 科学的理论和方法来检查和解决心血管疾病的多层次决定因素。原生 夏威夷人承受着高血压和心血管疾病的不成比例的负担。多层次干预 与高血压预防有关，因为血压受风险和保护因素的影响， 个人、家庭、社区、社会和环境层面。然而，研究这些因素的结果表明， 复杂的互动和过程是夏威夷土著人所缺乏的。这些信息对于制定一个 夏威夷原住民心血管健康的多层次理论模型，以指导文化相关的设计， 对这一未充分研究的群体进行多层次干预。Ing博士将利用她在社区为基础的经验， 参与和转化研究，以实现四个短期职业目标; 1）检查多层次 心血管健康的决定因素，2）使用系统科学的理论和方法，包括基于组 模型构建和社区系统动力学; 3）提高高血压的知识和技能， CVD预防，以及4）吸引夏威夷原住民社区成员和领导人。拟议研究 将与美国农业部资助的一项研究（儿童健康生活卓越中心）建立伙伴关系， 包括6个夏威夷原住民社区。其2019年的重新评估包括社会人口统计学，心理社会学， 行为、家庭和社区因素。通过利用这种伙伴关系，Ing博士将招募240名 成年人，用于收集有关血压、身高、体重以及行为和心理社会因素的额外数据 (e.g.,饮食、体力活动、歧视）。利用这些数据，她将研究 个人、家庭和社区因素与血压。此外，她将参与社区 6个焦点小组研讨会的领导者（n=48），以创建多层次之间感知联系的因果结构 因素和HTN。然后，她将综合定性数据和因果结构，以创建因果循环 图表。这个因果循环图将作为一个新的理论模型的心血管健康在本土 夏威夷人具体目标是：1）估计行为（体力活动，饮食， 酒精消费，烟草使用），生物（BMI），社会心理（文化适应，歧视），家庭 (size、组成、粮食短缺、粮食援助的使用）和社区（步行能力、粮食环境） 240名成年夏威夷原住民的因素和血压，以及2）通过焦点小组与社区领导人接触 讲习班，以创建一个因果循环图，描绘土著居民心血管健康的多层次决定因素 夏威夷社区拟议的研究连续性补充将确保已批准的项目 在英格医生的关键生命事件中取得了进展此外，它将保证她能够完全恢复 生产力和进步沿着她的轨迹独立。

The purpose of this supplement application is to support the research and career development of Dr. Claire Townsend Ing in establishing herself as an independent investigator engaging community and using system science theory and methods to examine and address multilevel determinants of cardiovascular disease. Native Hawaiians bear a disproportionate burden of hypertension and cardiovascular disease. Multilevel interventions are relevant for hypertension prevention as blood pressure is influenced by risk and protective factors at individual, family, community, societal, and environmental levels. However, research examining these factors’ complex interactions and processes is lacking in Native Hawaiians. Such information is critical to developing a multilevel theoretical model of Native Hawaiian cardiovascular health to guide the design of culturally relevant, multi-level interventions for this understudied group. Dr. Ing will build on her experience in community-based participatory and translational research to achieve four short-term career objectives; to 1) examine multilevel determinants of cardiovascular health, 2) use systems science theory and methods to include group-based model building and community-based system dynamics, 3) improve knowledge and skill in hypertension and CVD prevention, and 4) engage Native Hawaiian community members and leaders. The proposed research will build on a partnership with a USDA-funded study (Children’s Healthy Living Center of Excellence) that includes 6 Native Hawaiian communities. Its 2019 reassessment included sociodemographic, psychosocial, behavioral, household, and community factors. Through leveraging this partnership, Dr. Ing will recruit 240 adults for additional data collection on blood pressure, height, weight, and behavioral and psychosocial factors (e.g., diet, physical activity, discrimination). Using these data, she will examine the relationships between individual, household, and community factors and blood pressure. Additionally, she will engage community leaders in 6 focus group workshops (n=48) to create causal structures of perceived links between multilevel factors and HTN. She will then synthesize the qualitative data and causal structures to create a causal loop diagram. This causal loop diagram will serve as a novel theoretical model of cardiovascular health in Native Hawaiians. The specific aims are to: 1) estimate the associations between behavioral (physical activity, diet, alcohol consumption, tobacco use), biological (BMI), psychosocial (acculturation, discrimination), household (size, composition, food scarcity, use of food assistance), and community (walkability, food environment) factors and blood pressure in 240 adult Native Hawaiians, and 2) engage community leaders via focus group workshops to create a causal loop diagram depicting multilevel determinants of cardiovascular health in Native Hawaiian communities. The proposed research continuity supplement will ensure that the approved project progresses during Dr. Ing’s critical life event. Additionally, it will guarantee her ability to return to full productivity and advance along her trajectory to independence.