PR-OUTLOOK: PR Young Adults' Stress, Contextual, Behavioral & Cardiometabolic Risk

公关展望：公关年轻人的压力、背景、行为

• 批准号: 10020439
• 负责人: CYNTHIA MADELINE PEREZ
• 金额: $ 74.58万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-18 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10020439
• 关键词: Adult; Age; American Heart Association; Area; Assessment tool; Atherosclerosis; Attenuated; Behavioral; Behavioral Risk Factor Surveillance System; Biological Markers; Blood; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular Manifestation; Cholesterol; Chronic; Chronic Disease; Clinic; Clinical; Cohort Studies; Collaborations; Communities; Comparative Study; Data; Diabetes Mellitus; Diet; Discrimination; Early Intervention; Elderly; Ethnic group; Family; Feces; Fibrinogen; Foundations; Funding; Future; General Population; Generations; Goals; Guidelines; Hair; Health; Health Policy; Healthcare; Hurricane; Hyperlipidemia; Hypertension; Incidence; Individual; Inflammation; Infrastructure; Intervention; Island; Knowledge; Link; Longitudinal Studies; Measures; Medical; Methods; National Heart, Lung, and Blood Institute; Neighborhoods; Obesity; Obesity Epidemic; Observational Study; Participant; Physical activity; Physiological; Population; Positioning Attribute; Poverty; Prevalence; Prevention; Protocols documentation; Psychosocial Assessment and Care; Public Health; Puerto Rican; Puerto Rico; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Saliva; Sampling; Schools; Sleep disturbances; Smoking; Social support; Socioeconomic Status; Source; Specimen; Spirituality; Stress; Stroke; Surveys; Time; Urine; Woman; Work; aged; biobank; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; cohesion; cohort; contextual factors; fasting glucose; follow-up; improved; interest; low socioeconomic status; men; middle age; modifiable risk; mortality; perceived stress; physical inactivity; psychosocial; racial and ethnic; recruit; resilience; response; rural residence; social; sociodemographics; socioeconomics; stress resilience; stressor; synergism; trend; urban area; young adult

ABSTRACT In response to PAR-17-470, PR-OUTLOOK: “Puerto Rico (PR) Young Adults’ Stress, Contextual, Behavioral & Cardiometabolic Risk” will investigate psychosocial and sociodemographic determinants of cardiovascular disease (CVD) risk factors and overall cardiovascular health (CVH) among young adults (18-29 y) in PR, a markedly vulnerable but understudied population. Previous studies of CVD risk in Puerto Rico and elsewhere have largely focused on middle-age and elder adults, and there is little data on CVD risks and overall CVH among the current young adult population -a generation that grew during the obesity epidemic. Incident CVD and stroke have not declined over time or have even increased in younger individuals as opposed to in older adults. Our preliminary findings and Behavioral Risk Factor Surveillance System data suggest that Puerto Ricans aged 18-34 years have a high burden of CVD risk factors. No studies have examined overall CVH (a metric to assess progress toward the American Heart Association 2020 goals of improving CVH by 20% and reducing CVD mortality by 20%) in Puerto Ricans of any age. Evidence links psychosocial and neighborhood stressors with CVD risk factors but these associations have not been assessed among young adults in PR. In young adulthood, stress increases (i.e. financial, school-to-work, social/family transitions), behavioral risks peak, and health care is undervalued/prevention postponed. PR contextual factors (i.e., island’s financial crisis, hurricane María aftermath, neighborhood socioeconomics, urban vs. rural residence) also may contribute to CVD risk but have not been studied in young adults in PR. Puerto Ricans’ resilient factors, including family/social support, spirituality, and religiosity may attenuate risk as these factors are of known benefit to the general population, but their protective impact in young Puerto Ricans is unknown. Our study will fill knowledge gaps of prevalence of CVD behavioral and cardiometabolic risk factors and overall CVH among young adults in PR, and ascertain their psychosocial (individual and neighborhood-level) and sociodemographic determinants. We will establish an island-wide cohort of 3,000 young adults (18-29 y) using a multi-stage sampling of probabilistic plus community approaches; conduct comprehensive assessments (survey, anthropometric, physiological), and establish a biorepository (blood, hair, saliva, urine, stool) for future longitudinal studies of CVD risk, CVH, and mechanisms. PR-OUTLOOK will extend the reach of the NHLBI-funded PROSPECT study and leverage already developed research infrastructure, island wide collaborations, and relevant study protocols to maximize synergy/optimize resources between studies. Our study will fill important knowledge gaps regarding CVD risk among young adults in PR and identify priority targets for medical, public health and policy interventions for early CVD prevention. We also are well positioned to conduct comparative studies with older island Puerto Ricans (PROSPECT), mainland Puerto Ricans (HCHS/SOL), and US Black and White young adults (CARDIA), as many assessment tools are shared between studies, further adhering to guidelines of the PAR.

摘要 回应PAR-17 - 470，PR-OUTLOOK："波多黎各（PR）年轻人的压力，背景， 行为和心脏代谢风险"将调查 年轻人（18 - 29岁）的心血管疾病（CVD）危险因素和总体心血管健康（CVH） y）在PR中，一个明显脆弱但研究不足的人群。先前在波多黎各进行的CVD风险研究， 其他地方的研究主要集中在中年和老年人身上，关于心血管疾病风险和总体风险的数据很少。 CVH在目前的年轻成年人中-这一代人在肥胖流行期间成长。事件 心血管疾病和中风并没有随着时间的推移而下降，甚至在年轻人中有所增加，而不是在老年人中。 老年人我们的初步调查结果和行为风险因素监测系统数据表明，波多黎各 年龄在18 - 34岁的哥斯达黎加人有很高的心血管疾病风险因素负担。没有研究检查总体CVH（a 评估美国心脏协会2020年CVH改善20%的目标进展的指标， 降低心血管疾病死亡率20%）。证据将心理社会和邻里联系起来 压力源与心血管疾病风险因素，但这些协会尚未评估的年轻人在公关。 青年期，压力增加（即财务，学校到工作，社会/家庭过渡），行为风险达到峰值， 保健被低估/预防被推迟。PR背景因素（即，台湾金融危机， 玛丽亚飓风后，邻里社会经济，城市与农村居住）也可能有助于心血管疾病 风险，但尚未在年轻人中进行研究。波多黎各人的弹性因素，包括家庭/社会 支持、精神信仰和宗教信仰可能会降低风险，因为这些因素对一般人来说是有益的。 这些措施对波多黎各年轻人的保护作用尚不清楚。我们的研究将填补 PR年轻成人中CVD行为和心脏代谢风险因素以及总体CVH的患病率，以及 确定他们的社会心理（个人和社区一级）和社会人口决定因素。我们将 采用多阶段概率抽样法，在全岛范围内建立一个由3 000名年轻人（18 - 29岁）组成的队列 社区方法;进行全面评估（调查、人体测量、生理）， 建立生物储存库（血液、毛发、唾液、尿液、粪便），用于未来CVD风险、CVH的纵向研究， 机制等PR-OUTLOOK将扩大NHLBI资助的PROSPECT研究的范围，并利用已经 发展研究基础设施，全岛合作，以及相关的研究协议，以最大限度地 协同/优化研究之间的资源。我们的研究将填补有关CVD风险的重要知识空白 并确定医疗，公共卫生和政策干预的优先目标， CVD预防我们也有能力与波多黎各岛上的老年人进行比较研究 （前景），波多黎各大陆（HCHS/SOL），美国黑人和白色年轻人（CARDIA），尽可能多的 评估工具在研究之间共享，进一步遵守PAR的指导方针。