Stress Biology and Psychosocial stressors as mechanisms for Racial Health Disparities in Neural and Clinical Impairments of Multiple Sclerosis

项目摘要/摘要

Project Summary/ Abstract The current F99/K00 proposal outlines an integrated pre- and post-doctoral training plan that will result in the applicant being prepared to independently conduct cutting edge interdisciplinary biopsychosocial research. Training goals will augment her solidify her strengths with emerging skills while also attending to professional development and career advancement. The project proposed spans psychosocial stress related outcomes that impact neurological health, specifically as it pertains to MS. To reach this goal, the applicant proposes training in (TG1) Stress Biology which will build on her prior biobehavioral expertise to extend to novel biospecimens and study populations and to complement stress biology with subjective measures of stress and discrimination; (TG2) Neuroscience, especially structural (MRI) measures which complements her prior EEG work; (TG3) Multiple Sclerosis as a debilitating neurological disease with causes brain atrophy but for whom severity of cognitive and physiological clinical outcomes continue to elude the field; and (TG4) Racial Health Disparities which can help shed light on underpinnings for individual differences in clinical MS outcomes through application of theories like Weathering and Intersectionality. The proposal spans two primary sites with an established history of working together which allows the applicant to accomplish innovative work and with an experienced mentor team who work well together through a “community of learning” format and application of Agile Methodology to help the applicant achieve project milestones. The applicant’s long-term goal is to become a transdisciplinary scholar who excels at both stress biology and neuroscience as well as critical race theories and the phenomenology of health disparities. Not only does the applicant seek to increase diversity in the sciences, but the research proposed also will be instrumental for demonstrating the very real, tangible and seemingly intractable impact of racism and discrimination. To achieve these goals, the project proposes three aims as aligned with the aims F99/K00 guidelines. Aim 1b describes the dissertation progress thus far, which includes obtaining approvals for pilot data to establish feasibility at the study site as part of the applicant’s Research Internship, completing training in all study measures including MRI, clinical MS outcomes, hair cortisol assays and scoring self-reported measures, and collecting pilot data for power analysis calculations. Aim 1b outlines work to be completed during the F99, focusing on a conceptual model (and corresponding hypotheses) in which the primary association between brain atrophy and clinical MS outcomes is interrogated in terms of sources of health disparities and then specific moderators are proposed such as hair cortisol and discrimination. Aim 2 describes the postdoctoral research direction as possible next research steps and career moves that will set up the applicant’s career in a way that enhances likelihood of success as a transdisciplinary scholar advancing understanding of how stress gets under the skin to impact health.