An Interpersonal Relationships Intervention for Improving Cardiovascular Health in Youth

项目总结 心血管疾病在社会经济地位(SES)和种族/民族方面的差异明显 在我们的社会中，导致这些差异的过程从童年就开始了。之前的干预努力 有针对性地在健康行为方面改变个人生活方式，但在低SES、少数族裔方面成效有限 青春年华。我们提出了一种新的干预措施来降低低SES、少数族裔儿童(根据NIH的21岁以下)的心血管风险 准则)，它侧重于社会关系--特别是指导--作为建立双向关系的一种方式 对年轻人的简历健康有好处。这种干预的理由是基于工作表明， 社会支持对身体健康有好处，在工作中证明帮助他人是有关联的 拥有更健康的身体。在这项拟议的干预研究中，大学生将作为导师 小学生(8年级)。250名大学生和250名芝加哥公立学校的8年级学生将 随机选择担任导师/被辅导者或作为对照组。学生们将参加一个 每周一学年的辅导干预。评估将在以下三个时间点进行 学年。所有导师和被辅导者将来自低收入家庭和代表性不足的少数族裔 从而使我们能够专注于改善经历了 不成比例的美国简历负担。该项目的第一个目标是调查 导师可以降低低收入少数族裔青年的心血管风险(肥胖；血压；胆固醇；血糖) 被辅导者与8年级学生作为对照组。第二个目标是调查作为一名 与对照组相比，导师可以降低大学生导师的简历风险。 第三个目标是了解辅导如何影响心理社会、健康 行为和生物变量，以及这些变量是否在指导对简历健康的影响中起中介作用。 借鉴社会支持的压力缓冲模型，我们提出了辅导促进发展的观点 一种牢固的社会关系，可以支撑行为变化，从而减轻压力的影响 通过两条途径对炎症和心血管健康产生影响：心理、生理和健康行为。在 心理生理途径，指导创造更多的适应性认知、情感和行为 对生活应激源的反应，进而减轻交感神经和神经内分泌系统对 压力。随着时间的推移，这会减少炎症，改善简历健康。在健康行为途径中， 从指导关系中搭建脚手架可以缓解压力与有害健康行为的关联 这反过来又与炎症和简历健康有关。通过这项研究，我们采取了社会关系- 有针对性的初级预防方法，通过针对出现的心血管危险因素来缩小健康差距 并通过关注低收入人群，预测成年后临床心血管疾病的结果， 代表处境危险、服务不足和处境不利的青年群体的少数群体导师和被辅导者。

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.