Stress and Type 2 Diabetes among Indigenous Adults

原住民成年人的压力和 2 型糖尿病

• 批准号: 8728829
• 负责人: Melissa L. Walls
• 金额: $ 58.38万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-10 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8728829
• 关键词: Adult; Affect; Alcohol or Other Drugs use; American Indian and Alaska Native; American Indians; Amputation; Anishinabe; Anxiety; Anxiety Disorders; Biological Markers; Blood Pressure; Cardiovascular Diseases; Clinic; Clinical assessments; Collaborations; Communities; Data; Depressed mood; Development; Diagnosis; Diagnostic; Disadvantaged; Discrimination; Disease; Disease Progression; Distress; Economics; Emotional; Epidemic; Evaluation; Exercise; Fatigue; Feedback; General Population; Glucose; Goals; High Prevalence; Hydrocortisone; Hyperglycemia; Hypoglycemia; Indian reservation; Indigenous; Interview; Language; Link; Lipids; Long-Term Effects; Low Prevalence; Measurement; Measures; Mental Depression; Mental Health; Mental disorders; Minnesota; Modeling; Motivation; NIH Program Announcements; National Institute of Diabetes and Digestive and Kidney Diseases; Newly Diagnosed; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Ojibwe; Onset of illness; Participant; Patient Self-Report; Physiological; Population; Process; Property; Psychometrics; Psychosocial Stress; Recording of previous events; Research; Reservations; Resolution; Retinal Diseases; Risk Factors; Rural; Salivary; Self Care; Severity of illness; Staging; Stress; Surveys; Symptoms; Time; Trauma; Unemployment; Violence; Wisconsin; Work; base; biological adaptation to stress; cohort; community based participatory research; compliance behavior; coping; depressive symptoms; dietary restriction; emotional distress; experience; glycemic control; health disparity; innovation; interest; prevent; psychosocial; response; single episode major depressive disorder; stressor

DESCRIPTION (provided by applicant): This revised RO1 application is in response to the Health Disparities in NIDDK Diseases Program Announcement (PA-09-262). It focuses on American Indians (AI) whose rates of type 2 diabetes (T2D) are the highest in the world. This population also copes with disproportionate stressors including economic disadvantage, unemployment, community violence, discrimination, and the long- term effects of historical cultural traumas and losses. Yet, paradoxically, AI people tend to score lower on some self-report measures of stress and have lower prevalence rates of stress-related mental disorders such as major depressive episode and anxiety disorders. The goals of the proposed research are to advance measurement of stress processes among AI people through comparisons of stress biomarkers and self-report measures; and to use multiple indicators of stress including stress biomarkers to investigate the interactions between stress processes T2D disease progression and treatment compliance among AI adults. This community based participatory research is based on partnerships with five Ojibwe reservations in Minnesota and Wisconsin who invited the research team to work with their clinics. The first specific aim is to couple our existing preliminary data on community salient stressors with new qualitative feedback on existing measures to adapt and subsequently examine via pilot surveys the psychometric properties of stress measures for this population. The second specific aim is to investigate the relationship between stress biomarkers and self-reported psychosocial stressors, symptoms of distress, and diagnostic measures of anxiety, depression, and trauma to ascertain the degree to which self report measures are indicative of actual physiological stress levels among a cohort of 200 AI adults who have been recently diagnosed with T2D. The third specific aim is to follow a cohort of 200 recently diagnosed T2D AI adults for two years to investigate an innovative conceptual model (Figure 1) of multiple measures of stress processes, treatment compliance, mental health, and risk factors for disease complications

说明（由申请人提供）：此修订后的 RO1 申请是为了响应 NIDDK 疾病计划公告中的健康差异 (PA-09-262)。它重点关注美国印第安人 (AI)，他们的 2 型糖尿病 (T2D) 发病率是世界上最高的。这些人口还面临着不成比例的压力，包括经济劣势、失业、社区暴力、歧视以及历史文化创伤和损失的长期影响。然而，矛盾的是，人工智能人群在一些自我报告的压力指标上得分往往较低，并且与压力相关的精神障碍（如重度抑郁症和焦虑症）的患病率也较低。拟议研究的目标是通过比较压力生物标志物和自我报告措施来推进对人工智能人群压力过程的测量；并使用包括压力生物标志物在内的多种压力指标来研究 AI 成人 T2D 疾病进展和治疗依从性的压力过程之间的相互作用。这项基于社区的参与性研究是基于与明尼苏达州和威斯康星州五个奥及布威保留地的合作，他们邀请研究团队与他们的诊所合作。第一个具体目标是将我们现有的社区显着压力源初步数据与现有措施的新定性反馈结合起来，以适应并随后通过试点调查检查该人群压力措施的心理测量特性。第二个具体目标是调查压力生物标志物与自我报告的社会心理压力源、痛苦症状以及焦虑、抑郁和创伤的诊断测量之间的关系，以确定自我报告测量在多大程度上指示最近被诊断患有 T2D 的 200 名 AI 成年人的实际生理压力水平。第三个具体目标是对 200 名最近诊断出的 T2D AI 成年人进行为期两年的跟踪，以研究一种创新的概念模型（图 1），该模型对压力过程、治疗依从性、心理健康和疾病并发症的风险因素进行多种测量