Built environments on stroke risk and stroke disparities in a national sample

全国样本中关于中风风险和中风差异的构建环境

• 批准号: 9207809
• 负责人: NATALIE COLABIANCHI
• 金额: $ 62.49万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-01 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9207809
• 关键词: Address; Adult; African American; Age; American; American Heart Association; Area; Cardiovascular Diseases; Case Fatality Rates; Cause of Death; Characteristics; Chronic Disease; Cohort Studies; Communities; Coronary heart disease; Cost Measures; Country; Crime; Data; Data Collection; Data Set; Data Sources; Death Rate; Destinations; Development; Diabetes Mellitus; Dietary intake; Disease; Disease Outcome; Documentation; Environment; Environmental Risk Factor; Food; Future; Geography; Goals; Incidence; Individual; Institution; Intervention; Investigation; Link; Measures; Methods; Modification; Neighborhoods; Not Hispanic or Latino; Parents; Participant; Patient Self-Report; Persons; Physical activity; Physical environment; Planet Earth; Price; Protocols documentation; Race; Research; Research Personnel; Rest; Risk; Risk Factors; Role; Safety; Sampling; Secure; Social Environment; Social Network; Social support; Socioeconomic Status; Source; Southeastern United States; Stroke; Stroke prevention; United States; United States National Institutes of Health; aging population; behavioral outcome; built environment; cardiovascular risk factor; cohesion; cohort; community setting; cost effective; data sharing; disability; effective intervention; experience; geographic difference; improved; land use; member; mortality; novel; population health; public health relevance; racial difference; racial disparity; segregation; social; walkability

 DESCRIPTION (provided by applicant): Stroke is one of the leading causes of death and a top cause of serious long-term disability. A number of stroke risk factors have been established at the individual-level; however, these risk factors only partially explain stroke risk and account for only half of the racial disparities in stroke. Novel exposures of stroke risk must be identifie to improve our understanding of stroke risk and to develop effective interventions. Recently, built and social environments (BSEs) have been identified as important factors to examine to further our understanding of cardiovascular disease. However, to date no studies have examined the effect of BSEs on stroke risk. BSEs may also help to explain the large racial and geographic disparities in stroke rates although this has yet to be empirically examined nationally. The proposed study would address these gaps by utilizing a unique assembled cohort, namely the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The REGARDS cohort is a national sample of adults over age 45, with oversamples of African-American participants and persons in the stroke belt. The proposed study will expand the REGARDS study to examine the effects of BSEs on incident stroke risk and on racial and geographic disparities in stroke. These aims will be achieved by obtaining data on a broad range of BSE characteristics of the REGARDS participants' built environment (e.g., food availability, park availability, food prices, physical activity facility availability, land use, steet connectivity and neighborhood physical environment) and participants' social environment (objective crime, perceived crime, neighborhood SES, social cohesion, racial residential segregation, social support and social networks, and neighborhood social environment). The data will be obtained from a number of sources including secondary commercial and administrative sources, participant self-reports and primary audits using the Street View feature in Google Earth. Environmental data will be spatially linked to participant data of the REGARDS case-cohort study. The proposed study aims to 1) examine the extent to which BSEs contribute to incident stroke risk in the REGARDS study; and 2) determine the extent to which BSEs explain racial and geographic disparities in incident stroke. The proposed study builds on important preliminary studies and the extensive relevant experience of the investigative team, which includes prominent scholars across a number of institutions. The proposed research provides a cost-effective way to examine the importance of BSEs for stroke prevention across diverse community settings and racial groups. Identifying the BSE characteristics that are predictive of incident stroke and BSEs that contribute to racial and geographic disparities will help inform future modifications of environments to improve population health. At the end of the study period, the BSE data will be made available to others through the REGARDS data sharing protocols; thus the measures in the proposed study will be available to the greater scientific community for use in research pertaining to other disease outcomes.

 描述(申请人提供)：中风是导致死亡的主要原因之一，也是导致长期严重残疾的首要原因。许多中风风险因素已经在个体层面上被确定；然而，这些风险因素仅部分解释了中风风险和原因。 中风中只有一半的种族差异。必须确定新的卒中风险暴露，以提高我们对卒中风险的理解，并开发有效的干预措施。最近，建筑和社会环境(BSES)已被确定为重要的检查因素，以加深我们对心血管疾病的理解。然而，到目前为止，还没有研究检验BSES对中风风险的影响。BSES也可能有助于解释中风发生率在种族和地理上的巨大差异，尽管这还有待全国范围内的经验性检验。拟议的研究将通过利用一个独特的组合队列来解决这些差距，即中风(方面)队列中地理和种族差异的原因。CORES队列是45岁以上成年人的全国样本，非洲裔美国人参与者和中风带患者的样本过多。这项拟议的研究将扩展REAGES研究，以检查BSES对中风发病风险和中风种族和地理差异的影响。这些目标将通过获取参与者建筑环境(例如食物供应、公园供应、食品价格、体育活动设施可用性、土地使用、街道连通性和社区物理环境)和参与者的社会环境(目标犯罪、可感知犯罪、社区SES、社会凝聚力、种族居住隔离、社会支持和社会网络以及社区社会环境)的广泛BSE特征的数据来实现。这些数据将从若干来源获得，包括二级商业和行政来源、参与者自我报告和使用谷歌地球的街景功能进行的初步审计。环境数据将在空间上与有关案例队列研究的参与者数据相联系。这项拟议的研究旨在1)在RECES研究中检查BSES对卒中发病风险的贡献程度；以及2)确定BSES对发病卒中的种族和地理差异的解释程度。拟议的研究建立在重要的初步研究和调查小组广泛的相关经验的基础上，调查小组包括一些机构的知名学者。这项拟议的研究提供了一种经济有效的方法来检查BSES在不同社区环境和种族群体中预防中风的重要性。确定对卒中事件和导致种族和地理差异的BSE有预测作用的BSE特征，将有助于为未来改善环境以改善人口健康提供信息。在研究期结束时，疯牛病数据将通过有关数据共享协议提供给其他人；因此，拟议研究中的措施将提供给更多的科学界，用于与其他疾病后果有关的研究。