The Impact of a Race-Based Stress Reduction Intervention on Well-Being, Inflammation, and DNA methylation in Older African American Women at Risk for Cardiometabolic Disease

基于种族的减压干预措施对有心血管代谢疾病风险的老年非洲裔美国女性的健康、炎症和 DNA 甲基化的影响

• 批准号: 10633624
• 负责人: Karen Lynn Saban
• 金额: $ 67.89万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10633624
• 关键词: Address; African American; African American population; Age Years; Behavioral; Biological; Buffers; C-reactive protein; Candidate Disease Gene; Cardiometabolic Disease; Cardiovascular Diseases; Cessation of life; Chicago; Chronic; Chronic Disease; Chronic stress; Cognitive; Coping Skills; Coronary Arteriosclerosis; DNA; DNA Methylation; DNA Modification Process; Data; Development; Discrimination; Disease; Emotional; Environment; Epigenetic Process; Ethnic Origin; Ethnic Population; Exhibits; Face; Fatigue; Gene Expression; Genes; Goals; Health; Health education; High Prevalence; Hypertension; Individual; Inflammation; Inflammatory; Inflammatory Response Pathway; Interferon Type II; Interleukin-1 beta; Interleukin-6; Intervention; Investigation; Life Stress; Link; Longevity; Measures; Methylation; Minority; Minority Women; Molecular; New York City; Obesity; Outcome; Participant; Personal Satisfaction; Prediabetes syndrome; Problem Solving; Psychological Impact; Psychological Stress; Race; Randomized; Randomized, Controlled Trials; Reporting; Research; Resistance; Risk; Risk Factors; Salivary; Sexism; Sleep disturbances; Social support; Stress; Symptoms; TNF gene; Validation; Well in self; Woman; Work; acute stress; allostatic load; attentional control; biological adaptation to stress; biopsychosocial; cardiometabolic risk; coping; cytokine; depressive symptoms; disorder risk; effective intervention; effectiveness evaluation; empowerment; experience; health disparity; high risk population; improve minority health; improved; innovation; methyl group; mortality risk; novel; older women; perceived discrimination; post intervention; programs; psychologic; psychological distress; racial identity; racial population; racism; recruit; resilience; response; sex; stress reduction; stressor; theories

PROJECT SUMMARY This randomized controlled trial will evaluate the impact of a novel race-based stress reduction program on well-being, inflammatory burden, and DNA methylation (DNAm) in older African American (AA) women at risk for cardiometabolic disease (CMD). Although the number of deaths related to CMD continues to decline, that decline has slowed recently with AAs bearing a disproportionate burden. Furthermore, women face more sex- specific risk factors for increased adiposity and AA women have the highest prevalence of obesity, hypertension, and prediabetes compared to all other racial and ethnic groups. Chronic stress is associated with low-grade inflammation and increased CMD risk. Growing evidence demonstrates that stressors such as racism and discrimination are significant contributing factors to psychological distress, low-grade chronic inflammation, and CMD health disparities among minorities, particularly among older AA women who endure the intersection of both racism and sexism across their lifespan. Resilience, Stress, and Ethnicity (RiSE) is a group-based, 8-week intervention that integrates cognitive-behavioral strategies focused on the biopsychosocial impact of racism, racial identity development, and empowerment. Based on our preliminary work, we anticipate that participation in RiSE will reduce psychological distress and inflammation. Further, our previous work demonstrated that women with high levels of perceived discrimination have a greater proinflammatory cytokine response to acute stress and decreased DNAm of genes related to inflammation and hypertension. DNAm is one type of epigenetic process that modulates gene expression by adding or removing methyl groups to DNA in response to the environment. Studies demonstrate that hyper or hypo methylation of genes due chronic stressors, including racism and discrimination are significantly associated with CMD risk. Emerging evidence demonstrates that psychobehavioral interventions may modify methylation of stress response-related genes potentially buffering the impact of psychological stress at the molecular level. However, few studies have examined the impact of a psychobehavioral intervention on changes in DNAm and none have addressed chronic stress in older AA women.Therefore, the specific aims are: (1) Determine the extent to which participation in RiSE decreases stress-related symptoms and inflammatory burden in older AA women at risk for CMD; (2) Evaluate the extent to which RiSE increases the use of adaptive coping versus maladaptive coping strategies in older AA women at risk for CMD; and (3) Determine the extent to which participation in RiSE modifies DNAm of stress response- related candidate genes in older AA women at risk for CMD from baseline to post RiSE intervention. AA women 50 to 70 years of age who are at risk for CMD will be randomized into either an 8-week RiSE program or a health education program. RiSE is an innovative intervention that addresses perceived racism and discrimination at the individual level. Further, RiSE has the potential to improve the health of minority women impacted by racism and discrimination.

项目摘要 这项随机对照试验将评估一种新的基于种族的减压计划对 老年非裔美国人（AA）妇女的健康、炎症负担和DNA甲基化（DNAm）风险 心脏代谢病（CMD）。尽管与CMD相关的死亡人数继续下降， 最近下降速度放缓，AA承担了不成比例的负担。此外，女性面临更多的性- 肥胖增加的特定风险因素，AA女性肥胖患病率最高， 高血压和前驱糖尿病的比例。慢性压力与 轻度炎症和CMD风险增加。越来越多的证据表明， 种族主义和歧视是造成心理困扰、低级别慢性 炎症和少数民族之间的CMD健康差异，特别是在患有AA的老年女性中， 种族主义和性别歧视在他们的一生中相互交织。弹性、压力和种族（Resilience，Stress，and Ethnicity，RiSE） 基于小组的为期8周的干预，整合了专注于 种族主义的生物心理社会影响、种族认同发展和赋权。根据我们初步的 工作，我们预计参与RiSE将减少心理困扰和炎症。此外，我们的 以前的研究表明，被认为受到高度歧视的妇女， 促炎细胞因子对急性应激的反应和与炎症相关的基因的DNA m减少， 高血压DNAm是一种表观遗传过程，它通过添加或去除DNA来调节基因表达。 甲基对DNA的反应。研究表明， 由于慢性压力因素，包括种族主义和歧视，基因与CMD风险显着相关。 新出现的证据表明，心理行为干预可能会改变压力的甲基化 反应相关基因在分子水平上可能缓冲心理压力的影响。 然而，很少有研究检查心理行为干预对DNA m和DNA m变化的影响。 没有人解决老年AA妇女的慢性压力。因此，具体的目标是：（1）确定 参与RiSE降低老年AA患者应激相关症状和炎症负担的程度 有CMD风险的女性;（2）评估RiSE增加适应性应对的程度， 老年AA女性在CMD风险中的适应不良应对策略;（3）确定 参与RiSE改变了老年AA妇女的应激反应相关候选基因的DNA m， 从基线到RiSE干预后的CMD。AA女性50至70岁谁是在CMD的风险将是 随机分为为期8周的RiSE计划或健康教育计划。RiSE是一个创新的 采取干预措施，在个人层面上解决所认为的种族主义和歧视问题。此外，RiSE具有 改善受种族主义和歧视影响的少数群体妇女健康的潜力。