The effects of pandemic-related stressors on change in CVD Risk: The protective role of universal prevention

流行病相关压力源对 CVD 风险变化的影响：普遍预防的保护作用

• 批准号: 10615346
• 负责人: MARK Ethan FEINBERG
• 金额: $ 71.58万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-02 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615346
• 关键词: Acute; Anxiety; Blood Pressure; Body mass index; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Cardiovascular Diseases; Child; Child Mental Health; Cholesterol; Climate; Communicable Diseases; Conflict (Psychology); Couples; Data; Data Collection; Data Set; Development; Disasters; Disease; Dislocations; Distal; Economics; Education; Epidemic; Face; Family; Family member; Financial Hardship; Foundations; Frequencies; Funding; Future; Gender; Gene Expression; Glycosylated hemoglobin A; Health; Hostility; Income; Inflammatory; Interleukin-6; Intervention; Investigation; Knowledge; Link; Loneliness; Mediating; Mental Depression; Mental Health; Meta-Analysis; Myocardial Ischemia; Natural Disasters; Parents; Pathway interactions; Patient Self-Report; Peripheral; Personal Satisfaction; Phase; Physiological; Positioning Attribute; Prevention; Prevention program; Process; Public Health; Randomized; Recovery; Research; Risk; Risk Factors; Risk Marker; Role; Sampling; Social Distance; Social isolation; Societies; Socioeconomic Status; Stress; Surveys; Time; Work; cardiovascular disorder risk; climate change; coping; family building; follow-up; high risk; improved; inflammatory marker; intervention effect; lonely individuals; pandemic disease; pandemic impact; physical conditioning; post-pandemic; pre-pandemic; preventive intervention; programs; promote resilience; protective factors; randomized trial; resilience; social; stressor; stroke risk; universal prevention

ABSTRACT Although we are not yet in a position to estimate the total collateral damage to health and society due to the COVID-19 pandemic, widespread increases in stress, financial strain, depression/anxiety, family conflict, and social isolation during the pandemic may each have large and cumulative long-term impacts on physical health, particular via cardiovascular disease (CVD). For example, given that evidence from a large recent meta-analysis indicates that risk for stroke and ischemic heart disease is about 30% higher in lonely and socially isolated people, the CVD-related “consequences of social distancing may be profound”. Pandemic- related stressors, such as financial strain and social distancing, may be particularly difficult for families with young children. In this context, the proposed project is uniquely positioned to examine important theoretical and practical public health questions that will inform future efforts to minimize the negative collateral health impacts of infectious disease epidemics as well as other crises: To what extent did the COVID-19 pandemic increase CVD risk among parents and children? Which of the multiple stressors associated with such a crisis ̶ e.g., financial, mental health, social isolation, family conflict ̶were most strongly linked to increases in CVD risk among parents and children? Can universal prevention programming enhance parent and child resilience in order to protect against crisis-related stressors and mitigate crisis-related increases in CVD risk? Aim 1: To examine the magnitude of change in CVD risk (a) from pre-pandemic to a time point near the anticipated end of the pandemic (“post-pandemic”) and (b) from the “post-pandemic” time point to 18 months later. We will assess whether pandemic-period financial strain, mental health problems, and family conflict predict CVD risk changes. Aim 2. To examine whether random assignment to effective family prevention is associated with (a) a reduction in the hypothesized increase in CVD risk across the pandemic; (b) greater “recovery” in CVD health indicators over an 18 month period during which we expect most pandemic-related restrictions will have been eased; and (c) reduced associations between pandemic-related stressors and change in CVD risk (moderation). Aim 3: To examine whether gender or pre-pandemic indicators of socioeconomic status (income, education) moderate the associations examined in Aims 1 and 2. Impact. This project will result in new practical and theoretical knowledge that is important as we face increased frequency of infectious disease epidemics and climate change-related environmental disasters. Research that increases understanding of the stress-related processes within families that impact CVD health risk will inform future intervention approaches to reduce CVD risk during periods of family crisis, social- economic dislocation, and natural disasters. Understanding the factors that relate to risk and resilience will allow program developers to more precisely target salient mechanisms as well as families at highest risk.

摘要 虽然我们还不能估计由于 新冠肺炎大流行，压力普遍增加，经济压力，抑郁/焦虑，家庭冲突，以及 大流行期间的社会孤立可能对每个人的身体产生巨大和累积的长期影响 健康，特别是通过心血管疾病(CVD)。例如，考虑到最近一次大规模爆炸的证据 Meta分析表明，孤独的人患中风和缺血性心脏病的风险要高出约30% 对于社交孤立的人来说，与心血管疾病相关的“社交疏远的后果可能是深远的”。大流行- 相关的压力源，如经济压力和社会疏远，可能对患有以下疾病的家庭特别困难 年幼的孩子。在这一背景下，拟议的项目具有独特的地位，可以审查重要的理论 和实际的公共卫生问题，这将为今后最大限度地减少负面附带健康的努力提供信息 传染病流行以及其他危机的影响：新冠肺炎大流行在多大程度上 增加父母和孩子患心血管疾病的风险？与这种危机相关的多种压力源中的哪一种̶ 例如，经济、精神健康、社会孤立、家庭冲突̶与心血管疾病的增加关系最为密切 父母和孩子之间的风险？全民预防规划能否提高家长和儿童的复原力 为了防范危机相关的压力源，减少与危机相关的心血管疾病风险的增加？ 目标1：检查从大流行前到接近大流行的时间点心血管疾病风险(A)的变化幅度 预计大流行结束(“大流行后”)和(B)从“大流行后”时间点延长至18个月 后来。我们将评估大流行期间的经济压力、精神健康问题和家庭冲突 预测心血管疾病风险变化。目的2.检验随机分配到有效的家庭预防是否 与(A)整个大流行心血管疾病风险假设增加的减少有关；(B) 心血管疾病健康指标在18个月期间的“恢复”，在此期间，我们预计大多数与大流行有关的疾病 限制将会放松；以及(C)减少与大流行有关的应激源与 心血管疾病风险的变化(适度)。目标3：审查性别或大流行前指标 社会经济地位(收入、教育)缓和了目标1和目标2中审查的联系。 冲击力。这个项目将产生新的实践和理论知识，这在我们面临的问题上是重要的 传染病流行和与气候变化有关的环境灾害的频率增加。 增加对家庭内影响心血管疾病健康的压力相关过程的理解的研究 风险将为未来的干预方法提供信息，以在家庭危机期间降低心血管疾病风险，社会- 经济混乱和自然灾害。了解与风险和韧性相关的因素将 允许程序开发人员更精确地针对突出机制以及风险最高的家庭。