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NEIGHBORHOOD EFFECTS IN COMMUNITY TRIALS FOR CVD

CVD 社区试验中的邻里效应

基本信息

批准号：
6390131
负责人：
J Michael Oakes
金额：
$ 15.86万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-07-01 至 2004-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6390131
关键词：
cardiovascular disorder cardiovascular disorder epidemiology cardiovascular disorder prevention clinical research clinical trials community health services data collection methodology /evaluation disease /disorder proneness /risk geographic site health behavior human data human subject interview public health socioenvironment statistics /biometry

项目摘要

The objective is to evaluate "neighborhood effects" in community trials for cardiovascular disease (CVD) prevention. During the 1980s, the NHLBI/NIH funded three community trials to test programs aimed at reducing CVD risks. While each study reported favorable risk factor changes, many overall net differences between treatment and control sites were modest and/or statistically insignificant. New research suggests that these analyses may mask important within-site neighborhood-wise endpoint differences. It may be that (1) "place," above and beyond individual level measures, influences CVD-related behaviors and (2) overall program outcomes may be confounded by neighborhood level influences. This study employs rich and existing data from the (1) Pawtucket Heart Health Program (PHHP) and (2) the 1980 and 1990 decennial censuses. Multilevel statistical methods and a geographic information system (GIS) are used for analyses. Briefly, the specific aims are to: Determine the extent to which individual-level CVD related variables vary by neighborhood; Identify neighborhood-level predictors of CVD risk after adjusting for individual-level measures; Examine neighborhood-wise endpoint trends; Analyze dose effects (i.e., intervention process) in terms of neighborhoods; Evaluate the effect of different neighborhood definitions on findings; Find best methods for handling demographic trends when census data are gathered decennially; Advance multilevel and GIS methodologies in cardiovascular epidemiology; Contribute to an epidemiologic theory of "place." This cost-effective three year study is significant, innovative and timely. It will advance the multidisciplinary substantive understanding and methodological tools necessary for public health practice in the twenty-first century.

目的是评估心血管疾病（CVD）预防社区试验中的“邻里效应”。在20世纪80年代，NHLBI/NIH资助了三个社区试验，以测试旨在降低心血管疾病风险的项目。虽然每项研究都报告了有利的风险因素变化，但治疗点和对照点之间的许多总体净差异是适度的和/或统计上不显著的。新的研究表明，这些分析可能掩盖了重要的站点内邻近智能端点差异。这可能是：(1)“地点”，超越个人层面的措施，影响cvd相关的行为；(2)整体项目结果可能受到社区层面的影响。本研究采用了来自(1)帕塔基特心脏健康计划（PHHP）和(2)1980年和1990年十年一次的人口普查的丰富和现有数据。多层次统计方法和地理信息系统（GIS）用于分析。简而言之，具体目标是：确定个体水平的心血管疾病相关变量随社区变化的程度；在调整个人水平措施后，确定社区水平的心血管疾病风险预测因素；检查邻近端点趋势；从邻里角度分析剂量效应（即干预过程）；评估不同社区定义对调查结果的影响；在每十年收集一次人口普查数据时，找到处理人口趋势的最佳方法；推进心血管流行病学多层次和GIS方法研究对“地方”的流行病学理论有所贡献。这项具有成本效益的为期三年的研究具有重要意义、创新性和及时性。它将促进21世纪公共卫生实践所需的多学科实质性理解和方法工具。