The Study on Type-2 Diabetes and the Rural Experience regarding Stress and Self-management behaviors (STRESS) Project

项目总结/摘要 农村地区2型糖尿病（T2D）的患病率比城市地区高17%。此外，T2D是 根据《2020年农村健康人口》， 次报告.农村人口受可预防慢性病的影响尤其严重， 社会背景因素，如贫困，地理隔离，以及日常生活中持续暴露于压力源 living.总之，这些因素可能对T2D自我管理（T2D-SM）行为产生负面影响。 农村非裔美国人（RAAs）自我管理行为的行为解释，几乎没有 社会因素的作用已引起研究的注意。压力是一个特别引人注目的研究领域， 鉴于有强有力的证据表明其与高血压等慢性疾病和病症的联系， 和肥胖。该提案的目标是确定哪些压力源（即，一般与特定领域）是 T2D-SM行为的重要风险因素。该项目将调整环境负担能力模型， 探索生物社会和环境背景因素之间的中介，调节和相互作用 塑造T2D-SM行为。这项研究建立在社区参与研究的强大基础设施之上 在布拉索斯山谷地区探索包括生物测定压力（例如，唾液皮质醇） RAA伴T2D。指导本研究提案的两个具体目标是：1）确定 哪些心理社会压力可以解释患有T2D的RAA之间T2D自我管理行为的差异;以及 2)为了确定心理社会压力和生理压力标记之间的关系（例如，皮质醇） 来自患有T2 D的RAA。该研究将招募200名被诊断患有T2D的RAA，以确定 哪些压力源是影响自我管理行为的重要危险因素。对于目标1，研究将收集 并分析压力、健康状况、心理社会因素和糖尿病自我管理的主观测量 行为。对于目标2，该研究将检查唾液皮质醇，自我报告的压力源， T2D-SM行为。申请人认为，所提出的研究是创新的，因为它解决了 一个重要的公共卫生问题（即，压力和歧视），这主要是 在农村社区和疾病自我管理的背景下，拟议的研究是 意义重大，因为它有望提供心理社会压力和生理压力的有力证据 对T2D-SM行为的测量。该研究项目的结果可以为以下方面做出相当大的贡献： 公共卫生领域，因为它有可能揭示新的农村非洲裔美国人的健康。

PROJECT SUMMARY/ABSTRACT The prevalence of type 2 diabetes (T2D) is 17% higher in rural areas than in urban areas. Additionally, T2D is ranked as the third most important rural public health priority, according to the Rural Healthy People 2020 report. Rural populations are disproportionately affected by preventable chronic diseases exacerbated by social contextual factors such as poverty, geographic isolation, and persistent exposure to stressors in daily living. Together, these factors may have a negative impact on T2D self-management (T2D-SM) behaviors. Behavioral explanations for rural African Americans’ (RAAs) self-management behaviors, with virtually no research attention has been paid to the role of social factors. Stress is a particularly compelling area of study in light of strong evidence demonstrating its linkages to chronic diseases and conditions such as hypertension and obesity. The goal of this proposal is to determine which stressors (i.e., general versus domain-specific) are an important risk factor for T2D-SM behaviors. This project will adapt the Environmental Affordances Model to explore the mediating, moderating, and interactions among biosocial and environmental contextual factors shaping T2D-SM behaviors. The study builds upon a robust infrastructure from community-engaged research in the Brazos Valley region to explore the inclusion of biological assays for stress (e.g., salivary cortisol) among RAAs with T2D. The two specific aims that guide this research proposal are: 1) to determine the extent to which psychosocial stress explain differences in T2D self-management behaviors among RAAs with T2D; and 2) to determine the relationship between psychosocial stress and physiological stress markers (e.g., cortisol) from RAAs with T2D. The study will recruit 200 RAAs, who have been diagnosed with T2D, to determine which stressors are an important risk factors for self-management behaviors. For Aim 1, The study will collect and analyze subjective measures of stress, health status, psychosocial factors, and diabetes self-management behaviors. For Aim 2, The study will examine the association between salivary cortisol, self-reported stressors, and T2D-SM behaviors. The research proposed is innovative, in the applicants’ opinion, because it addresses an important public health problem (i.e., stress and discrimination) among RAAs, which has largely been ignored, within the context of rural communities and disease self-management. The proposed research is significant because it is expected to provide strong evidence of psychosocial stress and physiological stress measures on T2D-SM behaviors. The results of this research project can offer considerable contributions to the public health field because it has the potential to shed new light on the health of rural African Americans.