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.

摘要 在年轻人(18-24岁)中，大约10%-20%的人发展为晚期但无症状的动脉粥样硬化。 然而，心脏代谢性疾病(CMD)的预防还没有得到充分研究。在美国，三分之二的年轻人 在大学期间，他们采取了不良的生活方式行为，这是导致CMD风险的原因。例如, 以大学为基础的年轻人(CBYA)从事久坐行为(SB)，定义为非常低强度 以坐姿、仰卧或仰卧的姿势活动，每天约7小时。国家和国际公共卫生 各机构最近呼吁研究界更好地了解如何实施SB减少 战略。然而，尽管CBYA呈现了一个圈养的但未被充分研究的群体，我们对此缺乏了解 如何针对这种多维行为。我们的长期目标是在中国开展CMD的初级预防工作。 CBYA。为了支持这一目标，这项提案的总体目标是制定一项以证据为基础的、 多层次干预，以减少SB为目标。这项纵向观察性研究将招募一批 500名CBYA(18-24岁)，来自具有代表性的州立大学人口。每两次访问(12个月) 此外，我们将测量传统的和新的CMD风险生物标记物，并管理参与者问卷以 收集有关生活方式行为(饮食、时型、物质使用)和社会生态(个人、 个体内部的、个体间的)某人的预测因素。在接下来的7天内，将使用 大腿佩戴的倾斜仪，以及使用加速度计的体力活动和睡眠行为。SB上下文(电视， 交通、学术/职业、休闲电脑等)将使用生态瞬时值进行衡量 分析。目标1将确定总SB(T-SB)和特定于上下文的SB(CS-SB)中哪个更强 与CMD风险相关。某人授予CMD风险的程度可能取决于它所处的环境 发生。例如，在普通成年人中，看电视与CMD有更强的相关性。 而不是其他CS-SB。原因尚不清楚，但可能包括同时发生不健康的可能性更大。 看电视时的行为(如加工食品)。因此，目标2将确定CMD风险有多大 是由某人直接解释的，而不是由共同发生的生活方式行为间接调节的。然后Aim 3将会 确定多层次干预目标。到目前为止，现有的纵向研究主要集中在 关于不可更改的社会人口变量。我们将使用社会生态学模型来识别可修改的 预测者。最后，将使用干预映射协议来设计一个干预实现和 评估计划。这项创新的建议将加深我们对政务司司长和政务司司长的重要性的认识。 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，以 以CBYA的初级CMD预防为目标。未来发生高影响的可能性因以下因素而增强：大学 校园相对封闭非常适合多层次的干预；在大学期间采取的行为 步入成年；以及我们经验丰富的多学科团队。