An Interpersonal Relationships Intervention for Improving Cardiovascular Health in Youth

项目摘要 不同社会经济地位（SES）和人种/种族的心血管（CV）疾病差异明显 在我们的社会中，导致这些差异的过程开始于童年。以往的干预努力 有针对性的个人生活方式的改变，健康行为，但在低社会经济地位，少数 青年我们提出了一种新的干预措施，以降低低SES，少数民族儿童（21岁以下，由美国国立卫生研究院 指导方针），重点是社会关系-特别是指导-作为一种方式，以创造双向 对青少年CV健康的益处。这种干预的理由是基于工作表明，接受 社会支持对身体健康有益，并在工作中证明帮助他人与 更好的身体健康在这项拟议的干预研究中，大学生将担任导师， 小学生（8年级）。250名大学生和250名芝加哥公立学校八年级学生将 被随机分配为导师/学员或对照组。学生将参加一个 在一个学年中每周进行辅导干预。评估将在评估期间的3个时间点进行。 学年所有导师和学员将来自低收入家庭和代表性不足的少数族裔 因此，使我们能够专注于改善经历过以下疾病的高危人群的CV健康状况： 该项目的第一个目的是调查是否 导师可以降低低收入少数民族青年的心血管风险（肥胖、血压、胆固醇、血糖） 与对照组的八年级学生相比。第二个目的是调查是否作为一个 与对照组的大学生相比，导师可以降低大学生导师的CV风险。 第三个目标是了解指导如何影响心理社会、健康和心理健康的干预目标。 行为和生物变量，以及这些变量是否介导了指导对CV健康的影响。 借鉴社会支持的压力缓冲模型，我们提出，指导促进发展 强大的社会关系可以支撑行为变化，从而减轻压力的影响， 通过2个途径对炎症和心血管健康有影响：心理生理和健康行为。在 心理生理途径，指导创造更适应认知，情感和行为 对生活压力源的反应，这反过来又减轻了交感神经和神经内分泌系统的反应， 应力随着时间的推移，这可以减少炎症并改善CV健康。在健康行为途径中， 从指导关系中建立起的脚手架减轻了压力与有害健康行为的关联 这反过来又与炎症和CV健康有关。通过这项研究，我们采取了社会关系- 通过针对出现的心血管风险因素， 在生命早期，预测成年后的临床CV疾病结局，并关注低收入人群， 少数族裔导师和被辅导者，他们代表处于风险、服务不足和弱势的青年群体。

PROJECT SUMMARY Disparities in cardiovascular (CV) diseases by socioeconomic status (SES) and race/ethnicity are pronounced in our society, and the processes that lead to these disparities begin in childhood. Previous intervention efforts have targeted individual lifestyle changes in health behaviors, but with limited success in low SES, minority youth. We propose a novel intervention to reduce CV risk in low SES, minority children (under 21 by NIH guidelines) that focuses on social relationships – specifically mentoring – as a way to create bi-directional benefits for CV health in youth. The rationale for this intervention is based both on work showing that receiving social support has benefits for physical health, and on work demonstrating that helping others is associated with better physical health. In this proposed intervention study, college students will serve as mentors to elementary school students (8th graders). 250 college students and 250 Chicago Public School 8th graders will be randomized to either serve as a mentor/mentee or to be in a control group. Students will participate in a weekly mentoring intervention throughout one school year. Assessments will occur at 3 time points during the school year. All mentors and mentees will come from low-income families and underrepresented minority groups, thus allowing us to focus on improving CV health in an at-risk population that experiences a disproportionate share of the CV burden in the U.S. The first aim of the project is to investigate whether mentors can reduce CV risk (obesity; blood pressure; cholesterol; blood glucose) in low-income, minority youth mentees relative to a control group of 8th graders. The second aim is to investigate whether serving as a mentor can reduce CV risk in the college student mentors compared to a control group of college students. The third aim is to understand how mentoring influences the intervention targets of psychosocial, health behavior, and biological variables, and whether these variables mediate the impact of mentoring on CV health. Drawing from the stress buffering model of social support, we propose that mentoring fosters the development of strong social relationships that can scaffold behavioral changes and hence mitigate the effects that stress has on inflammation and CV health via 2 pathways: psychophysiological and health behaviors. In the psychophysiological pathway, mentoring creates more adaptive cognitive, emotional, and behavioral responses to life stressors, which in turn mitigate responses of the sympathetic and neuroendocrine systems to stress. Over time, this reduces inflammation and improves CV health. In the health behaviors pathway, the scaffolding from mentoring relationships mitigates the associations of stress with detrimental health behaviors that in turn are linked to both inflammation and CV health. Through this study, we take a social relationships- oriented primary prevention approach to reducing health disparities by targeting CV risk factors that emerge early in life and that predict clinical CV disease outcomes into adulthood and by focusing on low-income, minority mentors and mentees who represent an at-risk, underserved, and disadvantaged group of youth.