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

这项补充申请的目的是支持克莱尔博士的研究和职业发展 汤普森将自己确立为参与社区和使用系统的独立调查员 检查和解决心血管疾病的多水平决定因素的科学理论和方法。原生的 夏威夷人承受着不成比例的高血压和心血管疾病的负担。多层次干预 与预防高血压有关，因为血压受危险因素和保护因素的影响 个人、家庭、社区、社会和环境层面。然而，检验这些因素的研究 夏威夷原住民缺乏复杂的互动和过程。这些信息对于开发 夏威夷土著心血管健康的多层次理论模型，以指导与文化相关的设计， 针对这一研究不足的群体的多层次干预。丁博士将以她在社区为基础的经验为基础 参与性和转化性研究，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，包括基于群体的 建立模型和基于社区的系统动力学，3)提高高血压和 预防心血管疾病，以及4)让夏威夷原住民社区成员和领导人参与。拟议的研究 将与美国农业部资助的一项研究(儿童健康生活卓越中心)建立合作伙伴关系 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、心理社会、 行为、家庭和社区因素。通过利用这一合作伙伴关系，丁博士将招聘240名 关于血压、身高、体重以及行为和心理社会因素的额外数据收集的成年人 (例如，饮食、体育活动、歧视)。利用这些数据，她将研究两者之间的关系 个人、家庭和社区因素与血压。此外，她还将参与社区活动 领导参加了6个焦点小组研讨会(n=48)，以创建多层次之间感知的联系的因果结构 因子和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。这一因果环图将作为一种新的心血管健康理论模型 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(体重指数)、心理社会(文化适应、歧视)、家庭 (大小、组成、食物稀缺性、食物援助的使用)和社区(可步行、食物环境) 240名成年夏威夷原住民的因素和血压，2)通过焦点小组与社区领导人接触 讲习班，以创建描述土著心血管健康的多水平决定因素的因果环图 夏威夷社区。拟议的研究连续性补充将确保核准的项目 在丁博士的关键人生事件中取得了进展。此外，这将保证她有能力完全恢复 并沿着她走向独立的轨道前进。

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.