Social Contexts, Stress and Non-Communicable Disease Risk Factors across the Life Course: A Pilot Study in Nicaragua

整个生命过程中的社会背景、压力和非传染性疾病风险因素：尼加拉瓜的试点研究

• 批准号: 9766911
• 负责人: Kammi K. Schmeer
• 金额: $ 16.62万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766911
• 关键词: Address; Adolescence; Adolescent; Adolescent obesity; Adoption; Adult; Alcohol or Other Drugs use; Area; Attention; Biological; Biological Markers; Biosocial; Birth; Birth Rate; Cardiovascular Diseases; Caregivers; Cessation of life; Child; Childhood; Chronic stress; Cognitive; Collaborations; Communities; Complex; Data; Data Collection; Development; Economic Conditions; Economics; Emotional; Environment; Epidemiology; Family; Follow-Up Studies; Fostering; Future; Goals; Hair; Health; Health Policy; Health Status; Health behavior; Hydrocortisone; Interview; Joints; Lead; Life Cycle Stages; Longitudinal Studies; Measures; Mediating; Mental Health; Mothers; Names; Nicaragua; Nicaraguan; Outcome; Overweight; Pathway interactions; Physiological; Pilot Projects; Play; Policies; Population; Population Research; Population Study; Populations at Risk; Positioning Attribute; Prevention; Psychosocial Stress; Public Health; Research; Research Project Grants; Resources; Risk; Risk Factors; Role; Sampling; Schools; Shapes; Social Conditions; Social Environment; Source; Statistical Data Interpretation; Stress; Surveys; Testing; Woman; Work; base; cohort; design; dissemination research; electronic data; evidence base; follow-up; high risk; improved; innovation; low and middle-income countries; low income country; novel; nutrition; physical conditioning; population based; prevent; psychosocial; public health relevance; rapid growth; research data dissemination; response; social; tool

Project Summary Nicaragua is a low-income country where epidemiological and nutrition transitions have taken hold. Non- communicable diseases (NCDs) now account for 73% of all deaths, with cardiovascular diseases topping the list. As in other low- and middle-income countries (LMICs), prevention of NCDs is key to addressing this health crisis, given the limited health sector and family-based resources available to treat NCDs. Yet the recent research and policy efforts addressing NCDs in Nicaragua have focused on describing the rates and the need to treat NCDs in the adult population, with little attention to social and economic predictors of NCD risk factors or earlier life course stages. Adolescence is a period of the life course involving the adoption of risky health behaviors and the onset of health conditions related to multiple NCDs. It is critical that we understand the social contexts associated with NCD risk factors in this stage preceding adulthood. Further, Nicaragua has one of the highest adolescent birth rates in the region, suggesting that NCD risk factors may be biologically embedded through births at this stage, contributing to future increases in NCDs in Nicaragua. We propose capacity-building research by working with a local research organization, the Center for Demographic and Health Research (CIDS), in León, Nicaragua, to implement a longitudinal, population-based study of social/economic insecurities, stress and NCD risk factors among adolescents and their caregivers. This study builds on an existing cohort of almost 500 children and caregivers interviewed in 2012, to provide a new focus on NCD-related risk factors emerging as the children enter adolescence. Key risk factors at this stage include substance use, poor mental health, high BMI in adolescence. We will follow up with caregivers as well to determine changes in their NCD health risks over the 7-year period. Further, we will determine the role of chronic stress in the development of NCD risk factors by assessing psychosocial stress in adolescents and their caregivers and collecting a novel physiological marker of chronic stress exposure—hair cortisol—in adolescents. Through joint research and capacity building efforts, CIDS will develop their electronic data collection and statistical analysis abilities, which will be applied in this study and the development of future NCD research in Nicaragua.

项目摘要 尼加拉瓜是一个低收入国家，流行病和营养状况的转变已经站稳脚跟。非 传染性疾病（NCD）现在占所有死亡人数的73%，其中心血管疾病占首位。 名单与其他低收入和中等收入国家一样，预防非传染性疾病是解决这一健康问题的关键。 鉴于卫生部门和家庭可用于治疗非传染性疾病的资源有限，这一危机的严重性是显而易见的。然而，最近 尼加拉瓜应对非传染性疾病的研究和政策努力侧重于描述非传染性疾病的发病率和需求， 在成人人群中治疗非传染性疾病，很少关注非传染性疾病风险因素的社会和经济预测因素 或更早的生命历程阶段。青春期是生命历程中的一个阶段，涉及到采取危险的健康 行为和与多种非传染性疾病相关的健康状况的发生。我们必须了解 社会背景与成年前这一阶段的非传染性疾病风险因素有关。尼加拉瓜有一个 该区域青少年生育率最高的国家之一，这表明非传染性疾病的风险因素可能是生物学上的， 这一阶段的出生造成的潜在风险将导致尼加拉瓜未来非传染性疾病的增加。 我们建议通过与当地的研究组织， 人口与健康研究中心，在尼加拉瓜莱昂，实施一项基于人口的纵向研究， 研究青少年及其照顾者的社会/经济不安全感、压力和非传染性疾病风险因素。 这项研究建立在2012年采访的近500名儿童和照顾者的现有队列的基础上， 随着儿童进入青春期，新的重点是与非传染性疾病有关的风险因素。关键风险因素在此 阶段包括物质使用、心理健康状况差、青春期BMI高。我们将与护理人员跟进 以及确定他们在7年期间非传染性疾病健康风险的变化。此外，我们将确定 通过评估青少年的心理社会压力来评估慢性压力在NCD危险因素发展中的作用 和他们的照顾者，并收集一种新的生理标记物慢性应激障碍-头发皮质醇-在 青少年。通过联合研究和能力建设努力，CIDS将开发其电子数据， 收集和统计分析能力，这将应用于本研究和未来的发展 尼加拉瓜的非传染性疾病研究。