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

2 型糖尿病研究以及关于压力和自我管理行为（STRESS）项目的农村经验

• 批准号: 10264090
• 负责人: Idethia Shevon Harvey
• 金额: $ 17.78万
• 依托单位: TEXAS A&M UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-14 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264090
• 关键词: Address; Adherence; Adverse event; Affect; African American; Amputation; Area; Behavior; Behavior Therapy; Biological; Biological Assay; Biological Markers; Blindness; Chronic; Chronic Disease; Chronic stress; Complex; Consensus; Data; Development; Diabetes Mellitus; Diagnosis; Discrimination; Disease; Event; Exhibits; Exposure to; Foundations; Geography; Health; Health Status; Health behavior; Healthy People 2020; Hydrocortisone; Hypertension; Individual; Infrastructure; Institutes; Intervention; Kidney Diseases; Kidney Failure; Latinx; Light; Link; Literature; Measures; Mediation; Metabolic syndrome; Mission; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Patient Self-Report; Perception; Persons; Physiological; Pilot Projects; Population; Population Research; Poverty; Practice Management; Predictive Value; Prevalence; Psychosocial Factor; Psychosocial Stress; Public Health; Reporting; Research; Research Methodology; Research Project Grants; Research Proposals; Risk Factors; Rural; Rural Health; Rural Minority; Rural Population; Salivary; Sampling; Self Management; Shapes; Stress; Surveys; Testing; Texas; Treatment/Psychosocial Effects; Work; community engaged research; contextual factors; cost; diabetes self-management; experience; glucose metabolism; health disparity; hypothalamic-pituitary-adrenal axis; innovation; minority communities; physiologic stressor; prevent; psychobiologic; psychological distress; psychosocial; psychosocial stressors; public health priorities; recruit; rural African American; rural area; rurality; self-management program; social; social culture; stress management; stressor; urban area

PROJECT SUMMARY/ABSTRACT Type 2 diabetes (T2D) prevalence 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. Stress is a particularly compelling area of study in light of strong evidence demonstrating its linkages to chronic diseases and metabolic syndrome such as hypertension and obesity. The central hypothesis of this proposed study is that stress influences T2D SM behaviors. The rationale for the proposed research is that psychobiological measures provide compelling data linking poverty, chronic stress, and discrimination to poor T2D outcomes. This study will employ a data triangulation approach through which biological assays for stress will be combined with experiential stress survey data to access the intersections and interactions between stress and T2D SM behaviors among rAAs. The study builds upon a robust infrastructure from community-engaged research in the Brazos Valley region of Texas 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) determine the relationship between selected psychobiological markers of stress, psychosocial stress, and T2D SM behaviors and among rAAs with T2D; and 2) to determine the extent to which different forms of psychosocial stress (i.e., general versus domain-specific) contribute to differences in T2D SM behaviors among rAAs with T2D. The study will recruit 200 rAAs, who have been diagnosed with T2D to determine which stressors are important risk factors for self-management behaviors. For Aim 1, The study will examine the association between salivary cortisol, self-reported stressors, and T2D-SM behaviors. For Aim 2, The study will analyze the relationship of subjective self-reported measures of stress, health status, and psychosocial factors to the level of adherence to effective T2D SM behaviors. The research proposed is innovative, in the applicants’ opinion, because it addresses an important public health problem (discrimination and other chronic stressors ) in a population (i.e., AAs) largely ignored within the contexts of rurality and disease self- management. The proposed research is significant because it is expected to provide strong evidence of the effect of psychosocial and physiological stressors 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.

项目概要/摘要 农村地区 2 型糖尿病 (T2D) 患病率比城市地区高 17%。此外，T2D 排名 根据《2020 年农村健康人口》报告，农村公共卫生作为第三重要的农村公共卫生优先事项。乡村的 人口不成比例地受到可预防的慢性疾病的影响，而这些疾病因社会背景而加剧 贫困、地理隔离以及日常生活中持续面临压力等因素。一起， 这些因素可能对 T2D 自我管理 (T2D-SM) 行为产生负面影响。压力是一个 鉴于强有力的证据表明其与慢性疾病的联系，这是一个特别引人注目的研究领域 以及高血压、肥胖等代谢综合征。这项研究的中心假设是 压力会影响 T2D SM 行为。拟议研究的基本原理是心理生物学 测量提供了令人信服的数据，将贫困、长期压力和歧视与不良 T2D 结局联系起来。 这项研究将采用数据三角测量方法，通过该方法对压力进行生物测定。 结合经验压力调查数据，了解压力和压力之间的交叉点和相互作用 rAA 中的 T2D SM 行为。该研究建立在社区参与的强大基础设施之上 德克萨斯州布拉索斯谷地区的研究探索纳入压力生物测定（例如， 唾液皮质醇）在患有 T2D 的 rAA 中。指导本研究提案的两个具体目标是：1) 确定选定的压力心理生物学标记、社会心理压力和 T2D SM 行为以及患有 T2D 的 rAA 之间的行为； 2) 确定不同形式的影响程度 社会心理压力（即一般压力与特定领域压力）导致 T2D SM 行为的差异 患有 T2D 的 rAA 中。该研究将招募 200 名已被诊断患有 T2D 的 rAA 来确定哪些 压力源是自我管理行为的重要风险因素。对于目标 1，本研究将考察 唾液皮质醇、自我报告的压力源和 T2D-SM 行为之间的关联。对于目标 2，该研究将 分析主观自我报告的压力、健康状况和心理社会因素之间的关系 遵守有效的 T2D SM 行为的水平。所提出的研究具有创新性， 申请人的意见，因为它解决了一个重要的公共卫生问题（歧视和其他长期存在的问题） 在农村和疾病自我意识的背景下，人群（即 AA）中的压力源（压力源）在很大程度上被忽视了。 管理。拟议的研究意义重大，因为它有望提供强有力的证据 社会心理和生理压力源对 T2D-SM 行为的影响。本研究项目的成果 可以为公共卫生领域做出巨大贡献，因为它有可能为人们带来新的认识 非裔美国人农村地区的健康状况。