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新型基于种族的压力计划对 在非洲裔美国人（AA）妇女的福祉，炎症负担和DNA甲基化（DNA） 用于心脏代谢疾病（CMD）。尽管与CMD有关的死亡人数继续下降，但 由于AAS承担不成比例的负担，最近的下降已经放缓。此外，妇女面临更多性行为 - 肥胖和AA女性增加的特定危险因素的肥胖症患病率最高， 与所有其他种族和种族相比，高血压和前糖尿病。慢性压力与 低度炎症和CMD风险增加。越来越多的证据表明，诸如 种族主义和歧视是导致心理困扰的重要因素，低度慢性 少数群体之间的炎症和CMD健康差异 种族主义和性别歧视的交汇处在他们的一生中。韧性，压力和种族（上升）是 基于小组的8周干预措施，整合了认知行为策略 种族主义，种族认同发展和赋权的生物心理社会影响。基于我们的初步 工作，我们预计参与崛起将减少心理困扰和炎症。此外，我们的 以前的工作表明，感知歧视的女性具有更大的 促炎性细胞因子对急性应激的反应和与炎症和 高血压。 DNAM是一种表观遗传过程，它通过添加或去除来调节基因表达 甲基对DNA响应环境。研究表明，超级或低甲基化的 应有的慢性应激源（包括种族主义和歧视）的基因与CMD风险显着相关。 新兴证据表明，精神行为干预可能会改变压力的甲基化 与反应相关的基因可能缓冲分子水平的心理压力的影响。 但是，很少有研究研究心理狂热干预对DNAM和DNAM变化的影响 没有人能解决年龄较大的AA妇女的慢性压力。因此，具体目的是：（1）确定 参与兴起的程度可减少与压力有关的症状和炎症负担 有CMD风险的妇女； （2）评估上升的程度增加了自适应应对的使用与 适应不良的应对策略在年长的AA妇女中有危险的CMD； （3）确定在多大程度上 参与RISE会改变dnal的压力反应反应 - 与年龄较大的AA妇女的候选基因 CMD从基线到上升后干预。 AA妇女50至70岁，有CMD风险 随机分为为期8周的崛起计划或健康教育计划。崛起是一种创新的 在个人层面上解决种族主义和歧视的干预措施。此外，上升 潜力改善受种族主义和歧视影响的少数族裔妇女的健康。