Targeting Corrosive Couple Conflict and Parent-Child Coercion to Impact Health Behaviors and Regimen Adherence

针对腐蚀性夫妻冲突和亲子强迫影响健康行为和养生方案依从性

• 批准号: 9320891
• 负责人: Theodore Patrick Beauchaine
• 金额: $ 7.18万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-25 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9320891
• 关键词: Adherence; Adult; Affect; Affective; Aggressive behavior; Behavior; Behavioral; Beverages; Biological Assay; Blood Glucose; Child; Child health care; Childhood; Clinical; Coercion; Conflict (Psychology); Consumption; Corrosives; Dental caries; Development; Diabetes Mellitus; Diet; Disease; Disease Outcome; Distress; Eating; Emotional; Emotions; Food; Health; Health behavior; Hostility; Hypothalamic structure; Intervention; Link; Literature; Measures; Medical; Medicine; Metabolic Marker; Negative Reinforcements; Obesity; Oral health; Outcome; Pain; Parent-Child Relations; Parents; Patient Self-Report; Pattern; Periodontal Diseases; Peripheral Nervous System; Phase; Physiological; Pituitary Gland; Poison; Process; Punishment; Regimen; Reporting; Research; Sampling; Science; Self Care; Stress; Sympathetic Nervous System; Systemic disease; Testing; Toothbrushing; behavior change; body system; drinking; early childhood; experience; glucose monitor; interest; intimate partner violence; mortality; physical conditioning; productivity loss; programs; response; social; sugar; theories; tool

 DESCRIPTION (provided by applicant): Corrosive couple conflict (CCC) and coercive parent-child conflict constitute a ubiquitous, potent, and destructive (but modifiable) interpersonal poison to a wide range of adult and children's health outcomes. Such patterns are also linked with poor parent-child relationships and with more harsh punishment, which is associated with disturbed responses to environmental stresses (e.g., disruption in sympathetic nervous system and hypothalamic-pituitary-adrenocortical responses), a wide variety of adverse health outcomes in childhood, including dental caries, obesity, and diabetes related metabolic markers. This phase of NIH's Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change" necessitating identification of central interpersonal/social targets for maximal impact on far-reaching panoply of health outcomes. This project will focus on factors associated diabetes and oral health (though the processes affect many other disease outcomes). Both are associated with pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. As requested by the RFA, we will isolate three proximal health behaviors: (a) medical regimen adherence; (b) eating and drinking high sugar/calorie items; and (c) self-care behaviors. CCC/coercive parent-child conflicts are marked by an interrelated set of affective, behavioral, and physiological signatures. In the UH2 phase, we will identify/develop/validate assays. We will also identify/develop, and test interventions to reduce CCC/coercion targets. In the UH3 phase, we expect to conduct at least 2 studies to test whether reduction in targets results in improvement in adherence and other health behaviors of interest. One study will focus on parents and children, the other on adults in intimate relationships. Health behaviors related to diabetes and oral health problems will serve as dependent variables as will self-care behaviors in both diabetes and oral health. To place these health behaviors in the context of disease conditions and medical regimen adherence, we expect to focus one study on a sample of children with early childhood caries and the other study on an adult sample with diabetes.

 描述（由申请人提供）：腐蚀性夫妻冲突（CCC）和强制性亲子冲突对成人和儿童的健康结果构成普遍存在的、有效的、破坏性的（但可改变的）人际毒药。这种模式还与不良的亲子关系和更严厉的惩罚有关，而惩罚又与对环境压力的反应紊乱（例如，交感神经系统和下丘脑-垂体-肾上腺皮质反应的破坏）、儿童时期的各种不良健康结果有关，包括龋齿、肥胖和糖尿病相关的代谢标志物。 NIH 行为改变科学计划的这一阶段强调“行为改变的实验医学方法”，需要确定中心人际/社会目标，以最大程度地影响广泛的健康结果。该项目将重点关注与糖尿病和口腔健康相关的因素（尽管这些过程会影响许多其他疾病的结果）。两者都与疼痛、困扰、费用、生产力损失甚至死亡有关。它们共享重叠的医疗方案，由重叠的近端健康行为驱动，并影响从幼儿期到成年晚期的广泛发展跨度。根据 RFA 的要求，我们将隔离三种最接近的健康行为：(a) 遵守医疗方案； (b) 饮食高糖/热量食品； (c) 自我护理行为。 CCC/强迫性亲子冲突的特点是一系列相互关联的情感、行为和生理特征。在 UH2 阶段，我们将识别/开发/验证检测方法。我们还将确定/开发并测试干预措施，以减少 CCC/强制目标。在 UH3 阶段，我们预计将进行至少 2 项研究，以测试目标的减少是否会导致依从性和其他感兴趣的健康行为的改善。一项研究将重点关注父母和儿童，另一项研究将重点关注亲密关系中的成年人。与糖尿病和口腔健康问题相关的健康行为将作为因变量，糖尿病和口腔健康的自我护理行为也将作为因变量。为了将这些健康行为置于疾病状况和医疗方案依从性的背景下，我们希望将一项研究重点放在患有幼儿龋齿的儿童样本上，另一项研究重点放在患有糖尿病的成人样本上。