Building a Multidisciplinary Research Program to Address Hypertension Disparities:Exploring the Neurocognitive Mechanisms of a Self-Management Intervention for African American Women with Hypertension

项目摘要 随着非裔美国女性高血压的诊断和患病率持续上升， 这一群体特别容易发生中风、终末期肾病和过早死亡。尽管在那里 是否有干预措施来帮助患者管理慢性病，血液中存在显著的变异性 非裔美国女性的压力控制。当前帮助患者建立生活方式的方法 变化主要是“一刀切”的方法。自我管理行为需要认知努力-- 对于计划和目标设定，这些因素与大脑活动的不同模式有关，称为 “神经加工。”神经加工和自我管理行为之间的关系很差 明白了。我们的初步研究结果表明，健康信息行为与 (信息共享)和默认模式网络中的激活(包括内侧顶叶和 前额叶皮质和颞顶交界处，负责社会和情感思维模式) 还有前额叶腹内侧皮质(显示出在社会关系和健康之间起中介作用)。更好的 了解大脑活动(区分神经提示的能力)如何改变反应 我们的高血压教育计划将提高自我管理的精确度和剪裁 干预措施。这个项目的目标是开发和试点测试一种新设计的健康信息 加强行为干预以改善非裔美国女性高血压的自我管理。 使用功能磁共振成像，或fMRI，我们将检查大脑活动(默认模式网络 VS任务积极网络)以响应视频提示。我们将评估干预对 在样本的子集中探索与自我管理相关的神经认知过程 干预背后的神经生物学机制。这项工作将有助于减少 影响非裔美国妇女的巨大健康差距。这些发现将被用来支持未来 在更大的非裔美国人样本中检验我们的信息共享干预的效果的研究 患有高血压的女性。 琼斯博士的研究计划侧重于设计和测试自我管理干预措施，以改善 非裔美国女性的血压控制，以及个人神经过程的详细说明 与成功应对此类干预措施相关的概况。培训和指导计划将 促进三个领域的发展：1)干预设计和测试，2)认知神经科学，3) 大权在握。这个由经验丰富的导师和顾问组成的多学科团队将监督一系列 在这些领域的培训和研究活动，以确保琼斯博士未来的成功。超凡的资源 一所顶尖大学和一支指导团队，在这些主题领域培养初级教师方面取得了成功 让密歇根大学成为琼斯博士项目的理想环境。

PROJECT ABSTRACT With a continued increased in the diagnosis and prevalence of hypertension among African American women, this group is particularly vulnerable to stroke, end-stage renal disease, and premature death. Although there are interventions available to help patients manage chronic disease, there is significant variability in blood pressure control among African American women. Current approaches to aid patients in making lifestyle changes have primarily been “one size fits all” methods. Self-management behaviors require cognitive effort – for planning and goal-setting, these factors are associated with distinct patterns of brain activity, referred to as “neuroprocessing.” The relationship between neuroprocessing and self-management behavior is poorly understood. Findings from our pilot studies show a large correlation between health information behavior (information sharing) and activation in the default mode network (comprised of the medial parietal and prefrontal cortices, and temporo-parietal junctions and responsible for social and emotional modes of thought) and the ventromedial prefrontal cortex (shown to mediate links between social connection and health). A better understanding of how brain activity (ability to differentiate between neurological prompts) changes in response to our hypertension education programs will improve the precision and tailoring of self-management interventions. The objective of this project is to develop and pilot test a newly designed, health information behavior enhanced intervention to improve self-management of hypertension in African American women. Using functional magnetic resonance imaging, or fMRI, we will examine brain activity (default mode network vs. task positive network) in response to video prompts. We will assess the influence of the intervention on neurocognitive processes associated with self-management in a subset of the sample to explore the neurobiological mechanisms underlying the intervention. This work will contribute to the reduction of the tremendous health disparities affecting African American women. The findings will be used to support future studies examining the effects of our information sharing intervention in a larger sample of African American women with hypertension. Dr. Jones's program of research is focused on designing and testing self-management interventions to improve blood pressure control among African American women, as well as detailing the individual neuroprocessing profiles associated with successful response to such interventions. The training and mentoring plan will promote development in three areas: 1) intervention design and testing, 2) cognitive neuroscience, and 3) grantsmanship. This multidisciplinary team of experienced mentors and advisors will oversee a range of training and research activities in these areas to ensure Dr. Jones's future success. The exceptional resources of a top university and a mentoring team with proven success in developing junior faculty in these topic areas make the University of Michigan an ideal environment for Dr. Jones's project.