Cardiometabolic Risk Development and Management in Changing Neighborhoods: the Jackson Heart Study

不断变化的社区中的心脏代谢风险发展和管理：杰克逊心脏研究

• 批准号: 10452713
• 负责人: Sharrelle M Barber
• 金额: $ 67.17万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-04 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10452713
• 关键词: Adult; Affect; African American; African American population; Area; Barbering; Behavioral; Behavioral Research; Biological; Biomedical Research; Blood Pressure; Characteristics; Chronic Disease; Cohort Studies; Country; County; Data; Data Collection; Databases; Development; Diabetes Mellitus; Economics; Enrollment; Environment; Epidemiology; Evidence based intervention; Geography; Glycosylated hemoglobin A; Goals; Health Food; Health Services Accessibility; Healthcare; Heterogeneity; Hypertension; Incidence; Intervention; Investigation; Jackson Heart Study; Lead; Light; Link; Mediating; Methodology; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Persons; Physical environment; Policies; Population; Population Density; Prevention; Primary Health Care; Process; Psychosocial Factor; Public Health Schools; Research Personnel; Risk Factors; Role; Safety; Shapes; Social Conditions; Social Environment; Subgroup; Techniques; Time; Universities; base; built environment; cardiometabolic risk; cardiovascular disorder risk; cohort; contextual factors; diabetes control; diabetic; epidemiology study; fasting glucose; health disparity; health inequalities; high risk population; hypertension control; hypertensives; improved; insight; metropolitan; novel; population based; programs; psychosocial; racial disparity; residential segregation; social; social cohesion; therapy design; urban area

Project Summary It is well established that African Americans have higher levels of cardiometabolic risk factors than whites and are less likely to achieve hypertension and diabetes control. The neighborhood environment is a critical structural determinant of these disparities given the disproportionate exposure of African Americans to deleterious residential environments. In light of this, we propose using the JHS, a state of the art epidemiologic cohort of African Americans (n=5,306), combined with rigorously assessed neighborhood contextual factors to examine longitudinal associations between features of the physical, social, and local healthcare environment and cardiometabolic risk factor development and management over a 20-year period. Understanding the role of changing neighborhood environments in shaping cardiometabolic risk factor development and management is critical to improving causal inferences and developing appropriate policies and interventions designed to mitigate the burden of cardiometabolic risk factors in this high-risk population. Furthermore, understanding these changes in the unique context of the South, a region of the country with the highest burden of chronic disease and urban areas characterized by high proportions of African Americans, low population density, and geographically dispersed amenities, will allow us to better understand how neighborhood processes operate in this setting and better tailor ongoing prevention efforts. The primary goals of the proposed study are to: 1) compile a multilevel database of time-varying neighborhood contextual data (i.e. physical, social, and healthcare characteristics) that can be linked to the Jackson Heart Study (JHS)— a unique, state-of-the art cohort study of African Americans and 2) to examine longitudinal associations of changes in neighborhood contextual factors with HTN and DBM development and management. Aim 1 will examine longitudinal associations between time-varying physical and social neighborhood features and cardiometabolic risk factors among African American adults. Aim 2 will examine longitudinal associations between time-varying neighborhood physical and social features and HTN and DBM control. Aim 3 will examine associations between local access to primary care and cardiometabolic risk factor development and management and whether features of the physical and social environment modify associations. This project will build upon detailed neighborhood data collection from Exams 1-3, incorporate emerging neighborhood data collection techniques, and take advantage of the collaborative partnership established between the Drexel University Dornsife School of Public Health and the JHS through the Center for Integrative Approaches to Health Disparities.

项目摘要 众所周知，非裔美国人比白人有更高水平的心脏代谢风险因素 不太可能实现高血压和糖尿病的控制。附近的环境是至关重要的 这些差异的结构性决定因素，因为非洲裔美国人对 有害的居住环境。鉴于此，我们建议使用JHS，这是一种最先进的流行病学 非洲裔美国人队列(n=5,306)，结合严格评估的社区背景因素 检查物理、社会和当地医疗保健环境特征之间的纵向关联 和心脏代谢风险因素在20年期间的发展和管理。了解角色 改变邻里环境对心脏代谢危险因素发展和管理的影响 对于改进因果推断和制定适当的政策和干预措施至关重要 减轻这一高危人群心脏代谢危险因素的负担。此外，理解 这些变化在南方的独特背景下，是国家长期负担最重的地区 疾病和城市地区的特点是非裔美国人比例高，人口密度低，以及 地理上分散的便利设施，将使我们能够更好地了解邻里过程是如何在 这一环境并更好地调整了正在进行的预防工作。拟议研究的主要目标是：1) 编译随时间变化的邻居上下文数据的多级数据库(例如，物理、社会和 医疗保健特征)，可以与杰克逊心脏研究(JHS)相联系-一种独特的、最先进的 对非裔美国人的队列研究和2)检查社区变化的纵向关联 与HTN和DBM开发和管理相关的环境因素。目标1将纵向检查 时变的身体和社会邻里特征与心脏代谢危险因素的关系 在非裔美国成年人中。目标2将检验时间变化之间的纵向关联 社区物理和社会特征以及HTN和DBM控制。目标3将检查关联 在当地获得初级保健和心脏代谢风险因素的发展和管理之间 物理和社会环境的特征是否会改变联想。这个项目将建立在 从考试1-3收集详细的邻域数据，结合新兴邻域数据收集 技术，并利用德雷塞尔大学之间建立的合作伙伴关系 多恩西夫公共卫生学院和JHS通过卫生综合方法中心 差距。