Determinants and Consequences of Second-hand Smoke Exposure in African American

非裔美国人二手烟暴露的决定因素和后果

• 批准号: 8552044
• 负责人: Sharon K Davis
• 金额: $ 19.95万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-03-08 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8552044
• 关键词: Adult; African American; Area; Asthma; Biological; Biological Factors; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Characteristics; Child; Child health care; Childhood; Clinical Markers; Communities; Cross-Sectional Studies; Crowding; Decision Making; Development; Diabetes Mellitus; Disease; Environment; Environmental Tobacco Smoke; Exhibits; Exposure to; Family; Family Characteristics; Functional disorder; General Population; Health; Health Hazards; Household; Housing; Hypertension; Indium; Individual; Inflammatory; Instruction; Intervention; Life; Life Cycle Stages; Low income; Lung; Lung diseases; Malignant neoplasm of lung; Mediating; Medical; Mental Depression; Metabolic; Metabolic Diseases; Metabolism; Modeling; Neighborhoods; Parenting behavior; Parents; Pathogenesis; Pathway interactions; Positioning Attribute; Preventive Intervention; Psychosocial Factor; Public Health; Risk Behaviors; Role; Sampling; Smoke; Smoking; Social support; Societies; Stress; Surveys; System; Testing; Tobacco; Tobacco smoke; Tobacco smoking; Tobacco use; Toxin; Vascular Diseases; Work; base; cohort; density; early onset; effective intervention; health disparity; health equity; health literacy; high risk; insight; low socioeconomic status; men who have sex with men; population based; pre-clinical; predictive modeling; prevent; primary outcome; programs; smoking prevalence; social; success; therapy design; tobacco advertising; tobacco exposure

It is postulated that one of the most effective strategies to ameliorate health disparities is to reduce tobacco exposure among African-American (AA) children and their parents. Exposure to the deleterious effects of involuntary secondhand smoking remains a major public health hazard; particularly for the most vulnerable in our society ~ children. Population-based surveys indicate that approximately 50% of children manifest exposure to secondhand smoke (SHS); and that AA children exhibit the highest rates of SHS exposure. The high rate of SHS exposure in children is particularly alarming because the life-course of smoking-related diseases such as asthma, hypertension, diabetes and cardiovascular disease have their onset during childhood. We anticipate that children living in the predominately low-income, AA partner community targeted by this MSM CEHD Program are particularly vulnerable to this toxin exposure. However, the causes and pathobiological consequences of SHS exposure in AA children remain poorly defined. This project will provide the first in-depth characterization of the social determinants and effects of SHS exposure on cardiovascular, metabolic and pulmonary health in AA children. These studies will provide new insights that will guide the development of more effective interventions to prevent tobacco exposure in AA families. Our approach utilizes a socio-ecological model of childhood SHS exposure that posits a multi-level interplay between the child's neighborhood characteristics, family context and individual biological factors. Our working hypothesis poses that certain elements in the 'built environment' predispose AA children to increased involuntary tobacco exposure (e.g. high density of tobacco marketing outlets; crowded housing conditions). Secondly, we hypothesize that parents determine childhood SHS exposure by: 1) parent risk behaviors (e.g. parent tobacco smoking), 2) parent health literacy and 3) parent psychosocial factors that influence childhood SHS exposure (perceived stress; social support). The project's specific aims are: Aim 1: Define the neighborhood characteristics, psychosocial factors and parenting behaviors associated with high secondhand smoke exposure in African-American children. Aim 2: Define the relationship between secondhand smoke exposure during childhood and vascular dysfunction, a pre-clinical marker of cardio-metabolic disease. Aim 3: Develop a predictive model to identify vulnerable children at high-risk for SHS exposure.

据推测，改善健康差距的最有效的策略之一是减少非裔美国人（AA）儿童及其父母的烟草暴露。暴露于非自愿的二手烟的有害影响仍然是一个主要的公共健康危害;特别是对我们社会中最脆弱的群体-儿童。基于人口的调查表明，大约50%的儿童暴露于二手烟（SHS）; AA儿童表现出最高的SHS率 exposure.儿童接触SHS的比例之高尤其令人担忧，因为与吸烟有关的疾病，如哮喘、高血压、糖尿病和心血管疾病，在儿童时期就开始发病。我们预计，生活在主要是低收入的儿童，AA合作伙伴社区的目标是这个MSM CEHD计划特别容易受到这种毒素的暴露。然而，AA儿童SHS暴露的原因和病理生物学后果仍然不清楚。这 该项目将首次深入描述社会决定因素以及SHS暴露对AA儿童心血管、代谢和肺部健康的影响。这些研究将提供新的见解，指导制定更有效的干预措施，以预防AA家庭的烟草暴露。 我们的方法利用了儿童SHS暴露的社会生态模型，该模型假设儿童的邻里特征、家庭背景和个人生物因素之间存在多层次的相互作用。 我们的工作假设是，“建筑环境”中的某些因素使AA儿童易受非自愿烟草暴露增加的影响（例如，烟草销售网点密度高;拥挤的住房 条件）。其次，我们假设父母决定儿童SHS暴露：1）父母风险 行为（如父母吸烟），2）父母的健康素养和3）父母的心理社会因素，影响儿童SHS暴露（感知压力;社会支持）。该项目的具体目标是： 目标1：定义与非裔美国儿童高二手烟暴露相关的社区特征、心理社会因素和养育行为。 目标二：明确儿童时期二手烟暴露与心血管功能障碍（心血管代谢疾病的临床前标志物）之间的关系。 目标3：开发一个预测模型，以确定处于SHS暴露高风险的脆弱儿童。