Psychosocial Factors and Lupus Disease Progression Among African American Women

非裔美国女性的心理社会因素和狼疮疾病进展

• 批准号: 10690156
• 负责人: H. David Chae
• 金额: $ 67.43万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10690156
• 关键词: Address; Affect; African American; Age; Aging; Biological; Biological Markers; Blood; Buffers; C-reactive protein; Cardiovascular system; Cell Aging; Child Rearing; Chronic; Chronic Disease; Clinical; Clinical Trials; Communities; Data; Data Collection; Disadvantaged; Discrimination; Disease; Disease Management; Disease Pathway; Disease Progression; Face; Family Relationship; Financial Hardship; Gender; Health; Immune; Inflammation; Inflammatory; Infrastructure; Intervention; Investigation; Kidney; Knowledge; Length; Leukocytes; Linear Models; Link; Longitudinal Studies; Lupus; Lupus Erythematosus; Measures; Methods; Modeling; Nature; Neighborhoods; Organ; Outcome; Participant; Pathway interactions; Patients; Pattern; Physicians; Physiological; Population; Population Study; Poverty; Prevalence; Privatization; Process; Psychosocial Assessment and Care; Psychosocial Factor; Psychosocial Stress; Recording of previous events; Religion and Spirituality; Research; Research Design; Resources; Role; Sample Size; Science; Severities; Severity of illness; Social Environment; Social support; Socialization; Source; Spottings; Stress; Systemic Lupus Erythematosus; Techniques; Testing; Tissues; Universities; Venipunctures; Woman; Work; caregiving; chronic autoimmune disease; cohort; comorbidity; cytokine; experience; improved; longitudinal design; minimally invasive; mortality; multidisciplinary; population based; protective factors; psychobiologic; psychologic; psychosocial; psychosocial resources; psychosocial stressors; racial discrimination; racial disparity; racial identity; racial minority; recruit; response; social factors; social health determinants; socioeconomics; stress management; stressor; systemic inflammatory response; telomere; young woman

PROJECT SUMMARY/ABSTRACT There is a lack of research on systematic lupus erythematosus (SLE), a multisystem, chronic, autoimmune disease that shows clear patterns along racial and gender lines. African American women not only have a greater prevalence of SLE, but also experience greater severity and faster progression compared to their White counterparts, being more frequently affected by organ damage and comorbid conditions that emerge as a consequence of disease activity and disease-related chronic inflammation and tissue damage. Racial disparities in SLE complications and mortality are well documented; however, the reasons for these disparities are poorly understood. To address these gaps in knowledge, this study aims to: (1) examine the role that psychosocial stressors experienced by African American women have in exacerbating SLE in this population; (2) identify social factors and psychological resources that are protective or buffer the effects of stress on SLE-related health declines; and (3) explore the biological implications of psychosocial stressors and SLE, in relation to elevated systemic inflammation and accelerated aging at the cellular level. The experiences of African American women with SLE are particularly challenging, and include psychosocial stressors related to disease management, as well as disproportionately greater poverty and living in disadvantaged communities; in addition to routine stressors such as those associated with work, family and relationship demands, parenting, and caregiving. Experiences of racial discrimination constitute a qualitatively distinct source of psychosocial stress, adding to existing everyday hassles. In this study, we will examine how these stressors impact SLE severity and progression through a longitudinal study design. We will collect three waves of data from 480 African American women, all with validated SLE. Participants will be recruited from the Georgians Organized Against Lupus (GOAL) cohort, a truly one-of-a-kind, population-based study of SLE in Atlanta, including a full spectrum of patients from all levels of socioeconomic strata, across a range of disease severity. We will examine the effects of racial discrimination, financial and neighborhood-related strains, and other stressors associated with various role strains. Potential protective factors, including those related to racial identity and social support, will also be assessed. We will collect dried blood spots (DBS), a minimally invasive alternative to venipuncture, to examine indicators of biological dysregulation which we hypothesize will be impacted by psychosocial stress as well as SLE activity. This study will be the most in-depth investigation of the multifactorial nature of psychosocial stressors and their impact on SLE disease progression among African American women, and thus fills an important gap in the science on this understudied disease. This research is important in advancing knowledge of how aspects of the social environment and psychological processes impact health among African American women with SLE, and also contributes to scientific knowledge on the underpinnings of racial disparities in the progression of this disease.

项目总结/摘要 系统性红斑狼疮（SLE）是一种多系统、慢性、 自身免疫性疾病，表现出明显的模式沿沿着种族和性别线。非裔美国人不 不仅有更高的患病率SLE，但也经历了更严重和更快的进展相比， 与他们的白色同行相比，更频繁地受到器官损伤和共病状况的影响， 作为疾病活动和疾病相关的慢性炎症和组织损伤的结果出现。 SLE并发症和死亡率的种族差异已有充分记录;然而，造成这些差异的原因 人们对差异了解甚少。为了解决这些知识差距，本研究旨在：（1）研究 非裔美国妇女所经历的心理社会压力在这方面加剧了SLE， 人口;（2）确定保护或缓冲影响的社会因素和心理资源 压力对SLE相关的健康下降;（3）探讨心理社会压力的生物学意义， 系统性红斑狼疮，与全身炎症升高和细胞水平的加速衰老有关。 非裔美国女性SLE患者的经历尤其具有挑战性，包括 与疾病管理有关的心理社会压力因素，以及不成比例的贫困和生活水平 在弱势群体中，除了与工作、家庭和 关系需求，养育子女，和养育子女。种族歧视的经历构成了一种性质上的 心理社会压力的独特来源，增加了现有的日常麻烦。在这项研究中，我们将研究如何 这些应激源通过纵向研究设计影响SLE的严重程度和进展。我们将收集三个 来自480名非裔美国妇女的数据波，所有人都患有经验证的SLE。参加者将从 格鲁吉亚人抗狼疮组织（GOAL）队列，一项真正独一无二的，以人群为基础的SLE研究， 亚特兰大，包括来自所有社会经济阶层的全方位患者， 严重性。我们将研究种族歧视、金融和邻里关系紧张的影响， 与各种角色紧张相关的其他压力源。潜在的保护因素，包括与种族有关的因素 身份和社会支持，也将进行评估。我们将收集干血点（DBS），这是一种微创的 替代静脉穿刺，检查生物失调的指标，我们假设将是 受心理社会压力和SLE活动的影响。这项研究将是最深入的调查 心理社会压力的多因素性质及其对非洲SLE疾病进展的影响 美国妇女，从而填补了一个重要的空白，在科学上对这种欠研究的疾病。本研究是 重要的是推进知识的方面，社会环境和心理过程 影响非裔美国女性SLE患者的健康，也有助于科学知识， 这种疾病的发展中种族差异的基础。

项目成果

Anticipatory racism stress, smoking and disease activity: the Black women's experiences living with lupus (BeWELL) study.

预期种族主义压力、吸烟和疾病活动：黑人女性狼疮患者的经历 (BeWELL) 研究。

• DOI: 10.1007/s10865-021-00235-9
• 发表时间: 2021
• 期刊: Journal of behavioral medicine
• 影响因子: 3.1
• 作者: Spears,EricaC;Allen,AmaniM;Chung,KaraW;Martz,ConnorD;Hunter,EvelynA;Fuller-Rowell,ThomasE;Lim,SSam;Drenkard,Christina;Chae,DavidH
• 通讯作者: Chae,DavidH

Pathways linking census tract typologies with subjective neighborhood disorder and depressive symptoms in the Black Women's Experiences Living with Lupus (BeWELL) Study.

• DOI: 10.1016/j.healthplace.2021.102587
• 发表时间: 2021-07
• 期刊: Health & place
• 影响因子: 4.8
• 作者: Martz CD;Hunter EA;Kramer MR;Wang Y;Chung K;Brown M;Drenkard C;Lim SS;Chae DH
• 通讯作者: Chae DH

Association of age with health-related quality of life in a cohort of patients with systemic lupus erythematosus: the Georgians Organized Against Lupus study.

• DOI: 10.1136/lupus-2016-000161
• 发表时间: 2016
• 期刊: Lupus science & medicine
• 影响因子: 3.9
• 作者: Plantinga L;Lim SS;Bowling CB;Drenkard C
• 通讯作者: Drenkard C

Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry.

新诊断的全身性红斑狼疮患者的终末期肾脏疾病的发生率：佐治亚狼疮注册处。

• DOI: 10.1002/acr.22685
• 发表时间: 2016-03
• 期刊: Arthritis care & research
• 影响因子: 4.7
• 作者: Plantinga L;Lim SS;Patzer R;McClellan W;Kramer M;Klein M;Pastan S;Gordon C;Helmick C;Drenkard C
• 通讯作者: Drenkard C

Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus.

• DOI: 10.1177/0961203317693095
• 发表时间: 2017-09
• 期刊: Lupus
• 影响因子: 2.6
• 作者: Plantinga L;Lim SS;Bowling CB;Drenkard C
• 通讯作者: Drenkard C