Cardiometabolic Disease Prevention in College-based Young Adults: Mapping a Contextual Sedentary Behavior Intervention

大学年轻人的心脏代谢疾病预防：制定相关的久坐行为干预措施

• 批准号: 10417601
• 负责人: Lee Stoner
• 金额: $ 63.22万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10417601
• 关键词: Accelerometer; Adopted; Adult; Age; Arterial Fatty Streak; Behavior; Behavior Therapy; Biological Markers; Cardiometabolic Disease; Communities; Computers; Consultations; Development; Diet; Dietary Practices; Evaluation; Factor Analysis; Fibrinogen; Food; Future; General Population; Goals; Health; Health behavior; Hour; Individual; International; International Agencies; Intervention; Leisures; Life Style; Lipids; Longitudinal observational study; Measures; Mediating; Mediation; Modeling; Occupational; Participant; Physical activity; Physical environment; Physiologic pulse; Population; Posture; Predictive Factor; Primary Prevention; Process; Protocols documentation; Public Health; Questionnaires; Recreation; Research; Risk Factors; Self Efficacy; Strenuous Exercise; Supination; Television; Thigh structure; Transportation; Visit; World Health Organization; Wrist; base; cohort; college; design; disorder prevention; disorder risk; evidence base; experience; food consumption; implementation intervention; innovation; intervention mapping; multidisciplinary; novel; recruit; sedentary lifestyle; sleep behavior; social norm; sociodemographic variables; substance use; therapy design; tv watching; young adult

ABSTRACT Among young adults (18-24 years), a concerning 10-20% develop advanced but asymptomatic atherosclerotic lesions, yet cardiometabolic disease (CMD) prevention is understudied. In the U.S. two-thirds of young adults attend college, during which they adopt poor lifestyle behaviors that contribute to CMD risk. For example, college-based young adults (CBYA) engage in sedentary behavior (SB), defined as very low intensity behaviors in a seated, reclined, or supine postures, for ~7 hr/day. National and international public health agencies have recently called on the research community to better understand how to implement SB-reduction strategies. However, while CBYA present a captive but understudied population, we have scant understanding as to how to target this multi-dimensional behavior. Our long-term goal is the primary prevention of CMD in CBYA. To support this goal, the overarching aim of this proposal is to develop an evidence-based, multi-level intervention to target SB reduction. This longitudinal observational study will recruit a cohort of 500 CBYA (18-24 years) from a representative state college population. On each of the two visits (12 months apart) we will measure traditional and novel CMD risk biomarkers and administer participant questionnaires to collect information on lifestyle behaviors (diet, chronotype, substance use) and socio-ecological (individual, intra-individual, inter-individual) predictors of SB. Over the next 7 days, SB quantity will be captured using a thigh-worn inclinometer, and physical activity and sleep behaviors using accelerometry. SB context (television, transportation, academic/occupational, leisure computer, other) will be measured using ecological momentary analysis. Aim 1 will identify whether total SB (T-SB) or context-specific SB (CS-SB) is more strongly associated with CMD risk. The degree to which SB confers CMD risk likely depends on the context in which it occurs. For example, in the general adult population, television viewing is more strongly associated with CMD than other CS-SB. The reasons are unknown but may include the greater likelihood of co-occurring unhealthy behaviors (e.g., processed foods) while watching television. Therefore, Aim 2 will identify how much CMD risk is explained directly by SB, versus indirectly mediated by co-occurring lifestyle behaviors. Aim 3 will then identify multi-level intervention targets. To date, the existing longitudinal research has predominantly focused on non-modifiable socio-demographic variables. We will use a socioecological model to identify modifiable predictors. Last, will use the Intervention Mapping protocol to design an intervention implementation and evaluation plan. This innovative proposal will enhance our understanding of the importance of CS-SB and co- occurring behaviors to CMD risk. The final product will be an evidence-based CS-SB reduction intervention to target primary CMD prevention in CBYA. The likelihood of future high impact is enhanced by: college campuses are relatively contained are well-suited to multi-level interventions; behaviors adopted during college track into older adulthood; and our experienced multi-disciplinary team.

抽象的 在年轻人（18-24岁）中，有关10-20％的成年人发展了晚期但无症状的动脉粥样硬化 病变，但预防心脏代谢疾病（CMD）。在美国，三分之二的年轻人 上大学，在此期间，他们采取了不良的生活方式行为，导致CMD风险。例如， 大学的年轻人（CBYA）从事久坐行为（SB），定义为非常低的强度 坐着，斜倚或仰卧姿势的行为约7小时/天。国家和国际公共卫生 机构最近呼吁研究社区更好地了解如何实施SB 策略。但是，尽管CBYA提出了一个被俘虏但研究的人口，但我们的理解很少 关于如何针对这种多维行为。我们的长期目标是对CMD的主要预防 cbya。为了支持这一目标，该提案的总体目的是开发基于证据的， 多层干预以减少靶向SB。这项纵向观察研究将招募一组 来自代表州立大学人口的500 CBYA（18-24岁）。两次访问中的每一个（12个月 除外）我们将衡量传统和新颖的CMD风险生物标志物，并管理参与者问卷调查 收集有关生活方式行为（饮食，表型，药物使用）和社会生态（个人，， SB的个体内部，个体间的预测指标。在接下来的7天内，SB数量将使用 大腿磨损的斜率以及使用加速度计的体育活动和睡眠行为。 SB上下文（电视， 运输，学术/职业，休闲计算机，其他）将使用生态瞬间测量 分析。 AIM 1将确定总SB（T-SB）或上下文特定的SB（CS-SB）是否更强烈 与CMD风险相关。 SB承认CMD风险的程度可能取决于其上下文 发生。例如，在一般成人人群中，电视观看与CMD更加密切相关 比其他CS-SB。原因是未知的，但可能包括同时发生不健康的更大可能性 观看电视时的行为（例如加工食品）。因此，AIM 2将确定多少CMD风险 直接用SB来解释，而与同时发生的生活方式行为相比，间接介导。 AIM 3将 确定多层干预目标。迄今为止，现有的纵向研究主要集中在 在不可修改的社会人口统计学变量上。我们将使用社会生态模型来识别可修改 预测指标。最后，将使用干预映射协议来设计干预实施和 评估计划。这项创新的建议将增强我们对CS-SB和共同重要性的理解 发生CMD风险的行为。最终产品将是基于证据的CS-SB减少干预措施 靶标在CBYA中预防主要CMD。未来的高影响力的可能性得到了增强：大学 相对包含的校园非常适合多层干预；大学期间采用的行为 追踪成年期;以及我们经验丰富的多学科团队。