Social Connectedness and Health in the Blackfeet Community: An Investigation of Biopsychosocial Mediators

项目摘要/摘要 生活在蒙大拿州西北部黑脚保护区的美国印第安人的预期寿命 比居住在同一县的非西班牙裔白人的预期寿命短13岁，部分原因是 糖尿病、抑郁症和心血管疾病等慢性病发病率高得不成比例 疾病。虽然在其他种族中，社会联系已被证明与健康和疾病风险有关 在人工智能人群中，社会联系在健康差距中的预期作用尚不清楚。这 在关于一个可能抵消持久的人工智能健康差距的潜在因素的知识方面留下了一个严重的缺口。 我们之前在黑脚社区的横截面研究表明，低社会阶层之间的关系 连通性和健康风险因素，包括高水平的炎性细胞因子，高静息血 压力大，抑郁和焦虑症状严重，睡眠质量差。每一种结果 与慢性疾病的发生和发展有关，这些疾病对黑脚AI的影响不成比例 成年人。根据这些观察到的关系，社会联系可能会起到弹性的作用 在这个高危社区促进良好健康的因素。 为了解决这一关键的研究差距，黑脚人工智能成人(n=280)将参与一项纵向研究 2年以上，以捕捉在心理和身体健康以及社会方面有意义的长期变化 连通性。随着三个衡量标准在两年内平均分布，我们将跟踪长期 社会联系、心理健康、睡眠质量和与高血压风险相关的生物标记物的轨迹 炎症和心脏代谢性疾病，并调查这些轨迹之间的对应关系 (目标1)。在第一年，在14天的监测期内，我们将使用生态瞬时评估应用程序 将问题发送到参与者的手机，以调查短期动态关系 社会互动、社会连通性、睡眠质量和心理健康指数(即 抑郁和焦虑)(目标2)。在我们的所有模型中，我们都将考虑文化因素、体验和健康- 我们在过去与社区的工作中发现的相关风险因素，包括 童年和历史创伤，最近的创伤，感觉到的歧视，酗酒，吸烟状况，以及 药物使用。拟议工作的首要目标是了解未来的关系 BF AI成人的社会连通性与健康之间的关系。这将是第一个全面的、纵向的 研究社会连通性与人工智能健康风险因素的关系。这一知识 可能适用于其他具有类似文化价值观和健康差距的人工智能社区。成功 证明社会联系和健康相关结果之间的联系将使我们能够 制定未来的干预措施，以改善社会连通性，从而改善这一弱势群体的健康。

Project Summary/Abstract The life expectancy for American Indians (AIs) living on the Blackfeet reservation in Northwest Montana is 13 years shorter than the life expectancy of non-Hispanic Whites living in the same county, in part because of disproportionately high incidence of chronic diseases including diabetes, depression, and cardiovascular disease. While social connectedness has been shown to associate with health and disease-risk in other racial groups, in AI populations, the prospective role of social connectedness in health disparities is unknown. This has left a critical gap in knowledge regarding a potential factor which may offset enduring AI health disparities. Our previous cross-sectional work in the Blackfeet community indicates relationships between low social connectedness and health-risk factors including high levels of inflammatory cytokines, high resting blood pressure, high levels of symptoms of depression and anxiety, and poor sleep quality. Each of these outcomes is implicated in the onset and progression of the chronic diseases which disproportionately affect Blackfeet AI adults. Based on these observed relationships, it is possible that social connectedness may act as resilience factor which promotes good health in this at-risk community. To address this critical research gap, Blackfeet AI adults (n=280) will participate in a longitudinal study over 2 years in order to capture meaningful long-term changes in mental and physical health and social connectedness. With three measurements spaced evenly across the 2 years, we will track long-term trajectories of social connectedness, mental health, sleep quality, and biomarkers related to risk for inflammatory and cardiometabolic diseases, and investigate the correspondence between these trajectories (Aim 1). During Year 1, over a 14-day monitoring period, we will use an ecological momentary assessment app to deliver questions to participants’ mobile phones to investigate short-term dynamic relationships between social interactions, social connectedness, sleep quality and indices of mental health (i.e. symptoms of depression and anxiety) (Aim 2). In all of our models, we will consider cultural factors, experiences, and health- risk factors which we have been found to be relevant in our previous work with the community including childhood and historical trauma, recent trauma, perceived discrimination, alcohol use, smoking status, and medication use. The overarching goal of the proposed work is to understand prospective relationships between social connectedness and health in BF AI adults. This will be the first comprehensive, longitudinal study to investigate relationships between social connectedness and health risk factors in AIs. This knowledge could be applicable to other AI communities with similar cultural values and health disparities. Successful demonstration of associations between social connectedness and health-relevant outcomes will enable us to develop future interventions to improve social connectedness and thereby health in this vulnerable population.