Social and Cultural Influences on Cardiovascular Risk in South Asians

社会和文化对南亚人心血管风险的影响

• 批准号: 8605408
• 负责人: NAMRATHA R KANDULA
• 金额: $ 70.2万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8605408
• 关键词: Address; American; Americas; Asians; Atherosclerosis; Automobile Driving; Behavior; Behavior Therapy; Belief; Body mass index; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chinese People; Cohort Studies; Communities; Coronary heart disease; Data; Development; Diabetes Mellitus; Diet; Epidemiology; Ethnic group; Etiology; Family; Feeling; Food; Future; Generations; Goals; Health; Health Personnel; Health behavior; Heterogeneity; High Prevalence; Hispanics; Immigrant; India; Individual; Interdisciplinary Study; Intervention; Interview; Investments; Life; Link; Maintenance; Mediating; Mediator of activation protein; Methods; Minority; National Heart, Lung, and Blood Institute; Non-Insulin-Dependent Diabetes Mellitus; Overweight; Pakistan; Participant; Pathway Analysis; Personal Satisfaction; Physical activity; Population; Prevention; Prevention Research; Preventive Intervention; Provider; Qualitative Methods; Research; Research Methodology; Risk; Risk Factors; Social Controls; Social Environment; Social Network; South Asian; Structure; Testing; Time; United States; United States National Institutes of Health; Weight Gain; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular risk factor; cohort; density; health belief; improved; insight; meetings; member; mortality; network models; nutritional epidemiology; population based; preference; prevent; prospective; public health relevance; racial and ethnic; social; success; waist circumference

Project Summary: Individual-level interventions to prevent cardiovascular disease (CVD) have been met with limited success in many minority communities, partly because they do not address the sociocultural context in which individuals live and make food and physical activity choices. Widening our inquiry beyond the individual, to the larger social drivers can provide key insights into how social influences can be leveraged in interpersonal and community-level interventions to engage at-risk communities. Social networks influence health via many mechanisms: social influence and control; establishment of health beliefs and normative behaviors; feelings of shared identity and belonging; and provision of support. Social influences are key determinants of health; yet social network analysis has rarely been used to examine links between social networks and health in minorities. The Mediators of Atherosclerosis in South Asians Living in American (MASALA) study is the first population-based cohort of South Asians (SAs) in the United States and is a substantial investment by the National Institutes of Health to understand the CVD disparities in the rapidly growing SA population. We propose to leverage that investment to investigate social network structures and sociocultural drivers of CVD risk factors in the MASALA cohort. Social relationships an especially important influence on SAs health behaviors because 90% are immigrants who believe kinship and family are paramount with emphasis on collectivism, social control, and maintenance of group identity. Our data from the MASALA study show that SAs have the highest prevalence of diabetes, an important CVD risk factor, and the lowest levels of physical activity compared to Whites, Blacks, Hispanics, and Chinese in the Multiethnic Study of Atherosclerosis. We also find that sociocultural influences may be partly driving these disparities and that individual-level prevention efforts may not be as effective in the tightly-knit, family-oriented SA community. In the proposed ancillary project, the multidisciplinary research team will utilize quantitative social network methods to: 1) Uncover the unmeasured sociocultural drivers of variance in proximal CVD risk factors (body mass index, waist circumference, diet and physical activity behaviors); and qualitative methods to: 2) Investigate the meaning, significance, and function of SAs' social networks with respect to how they influence food and physical activity preferences and constraints. Qualitative interviews will provide greater context to the quantitative findings and elucidate mutable avenues for future intervention. Our team, with expertise in CVD prevention and nutritional epidemiology, sociocultural determinants of health, and social network analysis is well-poised to conduct this mixed methods research. The proposed research addresses critical gaps in CVD prevention research: understanding the influence of social networks on CVD risk and how these influences can be leveraged to improve the cardiovascular health of immigrant and minority communities.

项目摘要：预防心血管疾病（CVD）的个体水平干预措施已得到满足 在许多少数民族社区取得的成功有限，部分原因是它们没有解决少数民族社区的社会文化背景， 个体生活和做出食物和身体活动选择的环境。扩大我们的调查范围， 更大的社会驱动因素可以提供关键的见解，如何利用社会影响力在人际关系中， 和社区一级的干预措施，以使处于危险之中的社区参与进来。社交网络通过许多途径影响健康 机制：社会影响和控制;健康信念和规范行为的建立; 共同的身份和归属感;以及提供支持。社会影响是健康的关键决定因素;然而， 社会网络分析很少被用来研究社交网络和健康之间的联系， 少数群体 生活在美国的南亚人的动脉粥样硬化中介人（MASALA）研究是第一个 南亚人（SA）在美国的人口为基础的队列，是一个重大的投资， 美国国立卫生研究院了解快速增长的SA人口中的CVD差异。我们 建议利用该投资调查CVD的社会网络结构和社会文化驱动因素 MASALA队列中的风险因素。社会关系对SA的健康有特别重要的影响 因为90%的人是移民，他们认为亲属关系和家庭是最重要的， 集体主义、社会控制和维护群体身份。MASALA研究的数据显示， SA的糖尿病患病率最高，这是一个重要的心血管疾病风险因素， 在多种族动脉粥样硬化研究中，与白人、黑人、西班牙裔和中国人相比，我们 我还发现，社会文化的影响可能是造成这些差异的部分原因， 在紧密团结、以家庭为导向的SA社区中，努力可能不会那么有效。 在拟议的辅助项目中，多学科研究小组将利用定量社会 网络方法：1）揭示近端CVD风险因素中未测量的社会文化差异驱动因素 (body质量指数，腰围，饮食和体育活动行为）;和定性方法：2） 调查情景应用程序的社交网络的含义、意义和功能，以及它们如何影响 食物和体力活动的偏好和限制。定性访谈将提供更大的背景， 定量研究结果并阐明未来干预的可变途径。我们的团队拥有CVD方面的专业知识 预防和营养流行病学，健康的社会文化决定因素，以及社会网络分析， 准备好进行这种混合方法的研究。拟议的研究解决了CVD的关键差距 预防研究：了解社交网络对心血管疾病风险的影响，以及这些影响如何影响心血管疾病的风险。 改善移民和少数族裔社区的心血管健康。