Self-Management and Resilience Trajectories in African American Adults with Hypertension
非洲裔美国成人高血压患者的自我管理和恢复轨迹
基本信息
- 批准号:10544763
- 负责人:
- 金额:$ 24.15万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-12-30 至 2024-11-30
- 项目状态:已结题
- 来源:
- 关键词:AdultAfrican AmericanAfrican American populationAntihypertensive AgentsBehaviorBehavioralBiologyBlood PressureCellsChronicChronic DiseaseCognitionCommunitiesComplexDataDiabetes MellitusDiagnosisDisease ManagementExpenditureFamilyFosteringFutureGillsGlassGoalsHealthHealth PersonnelHealth protectionHeart failureHydrocortisoneHypertensionIncidenceIndividualIntakeInterleukinsInterventionIntervention StudiesLife Cycle StagesLife Style ModificationLinkLongitudinal cohortMalignant NeoplasmsMediatingMedicalMental DepressionModelingMorbidity - disease rateOutcomeParticipantPatient CarePatternPersonal SatisfactionPharmaceutical PreparationsPhysical activityPhysiologicalPopulation GroupPractice ManagementQuality of lifeRecommendationResearchRiskSamplingScienceSelf EfficacySelf ManagementSocietiesSodiumStressful EventTimeTreatment ProtocolsWorkbehavior changebiological adaptation to stressbiopsychosocialblood pressure controlcardiovascular disorder riskcare costscopingcostdesignemotion regulationgood diethealth managementhealth related quality of lifehypertension controlimprovedinstrumentmangemedication compliancemortalitymultiple chronic conditionsnegative emotional stateoptimismpatient orientedperceived stresspromote resilienceprotective factorspsychologicrecruitresiliencesmoking cessation
项目摘要
PROJECT SUMMARY/ABSTRACT:
Although substantial data are available on the treatment and management of hypertension (HTN), lifestyle
modification and medication adherence to antihypertensives therapy, self-managing HTN remains suboptimal
in African Americans (AA) and has major impacts on health outcomes and patient care cost with direct medical
expenditures estimated to cost $42.9 billion annually. Self-managing HTN to a blood pressure (BP) goal of
<130/80 mmHg presents challenges such as juggling multiple medications and health care providers, dealing
with complex recommendations and treatment regimens, and coping with negative emotional states.
Resilience can be an important factor that protects health, well-being, and quality of life in the context of self-
managing HTN. However, there has been a paucity of studies that have examined the biopsychosocial
mechanisms that foster effective HTN self-management and resilience among AA. Understanding the
mechanism that influence HTN self-management and resilience holds the promise of new modifiable targets
for behavior change interventions. This R21 application, Self-management and Resilience Trajectories in
African Americans with Hypertension, will explore the influence of resilience precursors on self-management
behaviors and on stress response, and the effects that these associations have on health outcomes (health-
related quality of life and BP) over a 6-month period. Our research is guided by the theoretical underpinnings of
both Glass and McAtee’s Society-Behavior-Biology Nexus of nested hierarchical influences on health and the
work of Szanton and Gill’s Society-to-Cell framework. Using a descriptive longitudinal cohort design, we will
recruit a convenient sample of 125 AA diagnosed with HTN with multiple chronic condition (MCCs).
Participants will be administered a battery of instruments to capture potential covariates, study variables, and
observe outcomes at baseline and months 3 and 6. The aims of this study are to [1] Assess the association
among resilience precursors (dispositional optimism and resilience, emotion regulation); stress response
(cortisol, interleukins, depression cognitions, perceived stress); HTN self-management behaviors and
capability (self-efficacy for chronic disease mangement, medication adherence to antihypertensives); and
health outcomes (HQROL, BP) among AA with HTN and MCCs at baseline and Months 3 and 6; [2] Determine
if stress response mediate the relationship between resilience precursors and health outcomes over time when
controlling for risk regulators; [3] Determine if self-management behaviors mediate the relationship between
resilience precursors and health outcomes over time when controlling for risk regulators; and [4] Identify
resilience trajectory patterns and factors that influence HTN self-management behaviors over time. This study
will advance self-mangement and resilience science through the identification and understanding of how
protective factors and resilience promote self-management behaviors and influence health at the individual
level and inform future interventional research intended to reduce CVD risks associated with suboptimal BP.
项目总结/摘要:
虽然大量的数据是关于高血压(HTN)的治疗和管理,
抗高血压治疗的修改和药物依从性,自我管理HTN仍然不理想
在非裔美国人(AA)中,对直接医疗的健康结果和患者护理成本有重大影响
估计每年的支出为429亿美元。自我管理HTN的血压(BP)目标
<130/80 mmHg带来了挑战,例如应付多种药物和医疗保健提供者,
复杂的建议和治疗方案,以及应对负面情绪状态。
复原力可以是在自我保护的背景下保护健康、福祉和生活质量的重要因素,
管理HTN。然而,很少有研究探讨生物心理社会学,
促进AA之间有效的HTN自我管理和恢复力的机制。了解
影响HTN自我管理和弹性的机制有望实现新的可修改目标
进行行为改变干预。此R21应用程序、自我管理和复原力轨迹
患有高血压的非洲裔美国人将探索弹性前体对自我管理的影响
行为和压力反应,以及这些协会对健康结果的影响(健康-
相关生活质量和BP)。我们的研究是由以下理论基础指导的:
格拉斯和麦卡蒂的社会-行为-生物学关系对健康的嵌套层次影响,
Szanton和Gill的Society-to-Cell框架。使用描述性纵向队列设计,我们将
招募125例诊断为HTN并伴有多种慢性疾病(MCC)AA的方便样本。
将向受试者提供一组工具,以捕获潜在的协变量、研究变量和
观察基线和第3个月和第6个月的结果。本研究的目的是[1]评估
弹性前体(性格乐观和弹性,情绪调节);压力反应
(皮质醇,白细胞介素,抑郁认知,感知压力); HTN自我管理行为和
能力(慢性疾病管理的自我效能,抗高血压药物的药物依从性);以及
在基线和第3个月和第6个月时,AA伴HTN和MCC的健康结局(HQROL,BP); [2]确定
如果随着时间的推移,压力反应介导了弹性前体和健康结果之间的关系,
[3]确定自我管理行为是否介导了
当为风险监管机构进行控制时,随着时间的推移,弹性前体和健康结果;以及[4]确定
弹性轨迹模式和影响HTN自我管理行为的因素。本研究
将通过识别和理解如何推进自我管理和弹性科学
保护性因素和复原力促进自我管理行为并影响个体的健康
水平和通知未来的干预性研究,旨在减少与次优血压相关的CVD风险。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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CAROLYN Harmon Still其他文献
CAROLYN Harmon Still的其他文献
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{{ truncateString('CAROLYN Harmon Still', 18)}}的其他基金
OPtimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP).
改善药物依从性和血压控制的优化技术 (OPTIMA-BP)。
- 批准号:
10470340 - 财政年份:2021
- 资助金额:
$ 24.15万 - 项目类别:
OPtimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP).
改善药物依从性和血压控制的优化技术 (OPTIMA-BP)。
- 批准号:
10294577 - 财政年份:2021
- 资助金额:
$ 24.15万 - 项目类别:
OPtimizing Technology to Improve Medication Adherence and BP Control (OPTIMA-BP).
改善药物依从性和血压控制的优化技术 (OPTIMA-BP)。
- 批准号:
10611508 - 财政年份:2021
- 资助金额:
$ 24.15万 - 项目类别:
Self-Management and Resilience Trajectories in African American Adults with Hypertension
非洲裔美国成人高血压患者的自我管理和恢复轨迹
- 批准号:
10369401 - 财政年份:2021
- 资助金额:
$ 24.15万 - 项目类别:
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