The impact of a culturally-based live music intervention on the metabolites and metabolic pathways associated with chronic stress and the risk of preterm birth in Black women

基于文化的现场音乐干预对与慢性压力相关的代谢物和代谢途径的影响以及黑人女性早产风险

• 批准号: 10559006
• 负责人: Elizabeth Jeanne Corwin
• 金额: $ 73.53万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-16 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10559006
• 关键词: 3-Dimensional; 37 weeks gestation; Academy; Address; Affect; Age; Baseline Surveys; Behavior; Bioinformatics; Biological; Biological Markers; Birth; Black race; Blinded; Chronic stress; Citric Acid Cycle; Clinic; Clinical; Clinical Trials; Control Groups; Corwin; Demographic Survey; Discipline of obstetrics; Discrimination; Disparity; Elements; Exposure to; First Pregnancy Trimester; Fundulus heteroclitus; Gestational Age; Glucocorticoids; Goals; Health; Health Disparities Research; Household; Human; Hydrocortisone; Individual; Infant; Inflammatory; Institute of Medicine (U.S.); Interdisciplinary Study; Intervention; Life Cycle Stages; Link; Mass Spectrum Analysis; Measures; Mediating; Medicine; Metabolic; Metabolic Pathway; Music; Music Therapy; National Institute on Minority Health and Health Disparities; Neighborhoods; Newborn Infant; Outcome; Oxidative Stress; Participant; Pathway Analysis; Patient Self-Report; Plasma; Population; Populations at Risk; Poverty; Pregnancy; Pregnancy Trimesters; Pregnant Women; Premature Birth; Production; Race; Randomized; Recording of previous events; Reporting; Research; Research Personnel; Resistance; Resolution; Risk; Risk Factors; Salivary; Sampling; Second Pregnancy Trimester; Socioeconomic Status; Stress; Surveys; System; Technology; Testing; Therapeutic; Therapeutic Intervention; Time; United States; Woman; adverse maternal outcomes; arm; black women; comparison intervention; cytokine; distraction; early experience; efficacy testing; experience; follow-up; food insecurity; group intervention; health disparity; health disparity populations; high risk; improved; improved outcome; infant outcome; innovation; intervention effect; low socioeconomic status; maternal stress; metabolic profile; metabolomics; myelination; neighborhood disadvantage; novel; perceived stress; pregnant; prenatal; racial disparity; recruit; saliva sample; sex; social health determinants; stem; stress reduction; stressor; tool; verbal

The health disparity in preterm birth (PTB) that exists in the United States (US) is a national crisis. Pregnant Black women have a 50% higher risk of PTB compared to pregnant White women in the US, and their infants are more than twice as likely to die. This disparity continues despite decades of research and tried intervention. Over ten years ago, the National Academy of Medicine identified Black women’s exposure to chronic stress as among the most important risk factors contributing to this health disparity and called for additional research as necessary. Although additional research has been conducted, the high rates of PTB among Black women have continued unabated. Thus, to address this significant critical need, we have brought together an exemplary team of researchers and clinicians with unique and complementary expertise. With this team, we will conduct a first of its kind clinic trial: testing the efficacy of a 10-week, live, culturally congruent music intervention compared to a similarly delivered 10-week sham control, to reduce the biological impact of chronic stress at the most fundamental level -- the molecules and metabolic pathways that are affected by stress. We further propose implementing the Music Characterization System (MCS) to identify the musical mechanisms underlying any benefit. Black women in the US often are exposed to chronic stress related to their race, sex, socioeconomic status, and social determinants of health including neighborhood and household food insecurity. Our study stems from our team’s previous research demonstrating that within a similar population of pregnant Black women, chronic stress was associated with changes in maternal metabolites and metabolic pathways linked to oxidative stress, energy production, and myelination, all potentially influencing pregnancy and newborn outcomes. This study also stems from our team’s rigorous research showing the power of live music to reduce stress and improve outcomes. Based on the National Institute of Minority Health and Health Disparities Research Framework, we will recruit 142 pregnant Black women during their 1st trimester of pregnancy and implement the Music Intervention or sham control beginning in the 2nd trimester. Women will collect saliva samples for later metabolomic analysis and complete surveys at the 1st, 5th, and 10th-week verbal or sham session. Birth outcomes will be determined from careful review of the labor and delivery record. Music is one of the earliest, most traditional art forms in human history, while metabolomics is one of the newest and most advanced technologies available in the world today. By combining the very old with the very new in this innovative study, we have the opportunity to identify a means by which the beneficial effects of live, culturally relevant music chosen by a pregnant woman and implemented therapeutically, can reduce the biological impact of the daily stressors to which she is exposed, and as a result, reduce one of the most persistent health disparities of our time, PTB.

美国（美国）存在的早产（PTB）的健康差异是一场国家危机。孕 与美国怀孕的白人妇女相比，黑人妇女的PTB风险高50％，她们 婴儿死亡的可能性是两倍以上。这种差距继续迫切了数十年的研究，并尝试了 干涉。十多年前，美国国家医学院确定了黑人妇女接触 慢性压力是导致这种健康差异的最重要的风险因素之一，并要求 必要的其他研究。尽管已经进行了其他研究，但PTB的率很高 在黑人妇女中，继续没有减弱。为了满足这一重大的关键需求，我们有 一起购买了一个具有独特和完整专业知识的研究人员和临床医生的典范团队。 在这个团队中，我们将进行此类诊所的第一个试验：测试10周，现场，文化的有效性 与同样交付的10周假控制相比，一致的音乐干预措施，以减少 慢性应激在最基本水平的生物学影响 - 分子和代谢途径 受压力的影响。我们进一步提出实施音乐表征系统（MCS）的提议 确定任何好处的音乐机制。美国的黑人妇女经常暴露于 与他们的种族，性别，社会经济地位和健康的社会决定者有关的慢性压力，包括 邻里和家庭粮食不安全。我们团队先前研究的研究工厂 证明在类似的怀孕黑人妇女中，慢性压力与 与氧化应激，能量产生和 髓鞘形成，所有可能都会影响妊娠和新生儿的结局。这项研究也从我们的 团队的严格研究表明了现场音乐的力量减轻压力和改善结果。基于 美国国家少数民族健康与健康差异研究框架研究框架，我们将招募142 怀孕的黑人妇女在怀孕的第一个三个月中实施音乐干预或假 控制从第二学期开始。妇女将收集唾液样本，以供以后的代谢组学分析和 在第1、5和第10周的口头或假疗中完成调查。将确定出生结果 仔细审查人工和交付记录。音乐是最早​​，最传统的艺术形式之一 人类历史，虽然代谢组学是最新，最先进的技术之一 当今世界。通过将非常旧的旧研究与这项创新研究中的新事物相结合，我们有机会 确定一种孕妇选择的生活，文化相关音乐的有益效果的手段 女性和实施理论可以减少她每天压力源的生物学影响 暴露了，因此减少了我们这个时代最持久的健康差异之一，PTB。