Cardiometabolic Risk Development and Management in Changing Neighborhoods: the Jackson Heart Study

不断变化的社区中的心脏代谢风险发展和管理：杰克逊心脏研究

• 批准号: 10228704
• 负责人: Sharrelle M Barber
• 金额: $ 65.98万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-04 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10228704
• 关键词: Adult; Affect; African American; Area; Barbering; Behavioral; Behavioral Research; Biological; Biomedical Research; Blood Pressure; Characteristics; Chronic Disease; Cohort Studies; Country; County; Data; Data Collection; Databases; Development; Diabetes Mellitus; Economics; Enrollment; Environment; Epidemiology; Evidence based intervention; Geography; Glycosylated hemoglobin A; Goals; Health Food; Health Services Accessibility; Healthcare; Heterogeneity; Hypertension; Incidence; Inequality; Intervention; Investigation; Jackson Heart Study; Lead; Light; Link; Mediating; Methodology; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Persons; Physical environment; Policies; Population; Population Density; Prevention; Primary Health Care; Process; Psychosocial Factor; Public Health Schools; Research Personnel; Risk Factors; Role; Safety; Shapes; Social Conditions; Social Environment; Structure; Subgroup; Techniques; Time; Universities; base; built environment; cardiometabolic risk; cardiovascular disorder risk; cohort; contextual factors; diabetes control; diabetic; epidemiology study; fasting glucose; health disparity; health inequalities; high risk population; hypertension control; improved; insight; metropolitan; novel; population based; programs; psychosocial; residential segregation; social; social cohesion; therapy design; urban area

Project Summary It is well established that African Americans have higher levels of cardiometabolic risk factors than whites and are less likely to achieve hypertension and diabetes control. The neighborhood environment is a critical structural determinant of these disparities given the disproportionate exposure of African Americans to deleterious residential environments. In light of this, we propose using the JHS, a state of the art epidemiologic cohort of African Americans (n=5,306), combined with rigorously assessed neighborhood contextual factors to examine longitudinal associations between features of the physical, social, and local healthcare environment and cardiometabolic risk factor development and management over a 20-year period. Understanding the role of changing neighborhood environments in shaping cardiometabolic risk factor development and management is critical to improving causal inferences and developing appropriate policies and interventions designed to mitigate the burden of cardiometabolic risk factors in this high-risk population. Furthermore, understanding these changes in the unique context of the South, a region of the country with the highest burden of chronic disease and urban areas characterized by high proportions of African Americans, low population density, and geographically dispersed amenities, will allow us to better understand how neighborhood processes operate in this setting and better tailor ongoing prevention efforts. The primary goals of the proposed study are to: 1) compile a multilevel database of time-varying neighborhood contextual data (i.e. physical, social, and healthcare characteristics) that can be linked to the Jackson Heart Study (JHS)— a unique, state-of-the art cohort study of African Americans and 2) to examine longitudinal associations of changes in neighborhood contextual factors with HTN and DBM development and management. Aim 1 will examine longitudinal associations between time-varying physical and social neighborhood features and cardiometabolic risk factors among African American adults. Aim 2 will examine longitudinal associations between time-varying neighborhood physical and social features and HTN and DBM control. Aim 3 will examine associations between local access to primary care and cardiometabolic risk factor development and management and whether features of the physical and social environment modify associations. This project will build upon detailed neighborhood data collection from Exams 1-3, incorporate emerging neighborhood data collection techniques, and take advantage of the collaborative partnership established between the Drexel University Dornsife School of Public Health and the JHS through the Center for Integrative Approaches to Health Disparities.

项目摘要 众所周知，非洲裔美国人的心脏代谢危险因素比白人高，并且 实现高血压和糖尿病控制的可能性较小。邻里环境是关键的 鉴于非洲裔美国人暴露于 有害居民环境。鉴于此，我们建议使用JHS，即技术流行病学的状态 非裔美国人队列（n = 5,306），再加上严格评估的邻里情境因素 检查物理，社会和当地医疗保健环境的特征之间的纵向关联 以及在20年内的心脏代谢风险因素开发和管理。了解角色 改变邻里环境以塑造心脏代谢风险因素的发展和管理 对于改善因果推断和制定适当的政策和干预措施至关重要 减轻这种高风险人群中心脏代谢危险因素的爆炸。此外，理解 这些变化在南方的独特背景下，该国的慢性负担最高 疾病和城市地区，其特征是非洲裔美国人，人口密度低和 地理分散的设施，将使我们能够更好地了解邻里过程的运作方式 这种环境和更好的量身定制的预防努力。拟议研究的主要目标是：1） 编译随时间变化的社区上下文数据的多级数据库（即物理，社交和 可以与杰克逊心脏研究（JHS）相关的医疗特征） - 独特的，最先进的 非洲裔美国人的队列研究和2）检查社区变化的纵向关联 HTN和DBM开发和管理的上下文因素。 AIM 1将检查纵向 随时间变化的身体和社交社区特征与心脏代谢风险因素之间的关联 在非裔美国人中。 AIM 2将检查时变的纵向关联 邻里物理和社会特征以及HTN和DBM控制。 AIM 3将检查关联 在本地获得初级保健和心脏代谢风险因素的发展和管理之间以及 物理和社会环境的特征是否会修改关联。这个项目将基于 考试1-3的详细邻里数据收集，合并的新兴邻里数据收集 技术，并利用Drexel大学之间建立的合作伙伴关系 Dornsife公共卫生学院和JHS通过综合方法的健康中心 差异。