Understanding the impact of racism—a social determinant of health—on the scope of the co-occurrence of mental health and cardiometabolic challenges in high-disparity racial/ethnic minority populations

了解种族主义（健康的社会决定因素）对高度差异的种族/族裔少数群体中心理健康和心脏代谢挑战同时发生的范围的影响

• 批准号: 10615963
• 负责人: Norman Bruce Anderson
• 金额: $ 12.5万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-23 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615963
• 关键词: Address; Anxiety; Behavioral; Big Data; Cardiovascular system; Clinical; Communities; Community Surveys; Complex; Computer Simulation; Data; Development; Disease; Disease Management; Disparity; Epidemiologist; Focus Groups; Future; Goals; Health; Individual; Intervention; Maps; Measures; Mental Health; Mental disorders; Metabolic; Modeling; Outcome; Persons; Primary Care; Process Assessment; Research; Risk; Risk Factors; Science; Syndrome; System; Training; Translating; United States; Work; adverse outcome; anti-racism; behavioral and social science; cardiometabolism; community based participatory research; comorbidity; cost; design; disability; disparity reduction; epidemiology study; ethnic minority; ethnic minority population; health care availability; health care service; health care service utilization; implementation science; implementation strategy; integrated care; member; models and simulation; optimal treatments; parent project; racial disparity; racial minority population; racism; social; social determinants; social health determinants; social influence; therapy development

This diversity supplement will build upon my training as a social epidemiologist to connect the dots between the epidemiologic research that seeks to understand the complex drivers and mechanisms of disparities in outcomes related to comorbid cardiometabolic and mental health conditions, implementation science and social determinants. Cardiometabolic syndrome (CMetS) and anxiety are highly prevalent and complicate management of each other when they co-occur, leading to greater disability and healthcare utilization and costs. Such multi- comorbidity becomes even more challenging when it intersects with racial inequities and social determinants of health culminating in amplified risk of adverse outcomes. Successful disease management that works at the intersection of the individual and the community must be implemented to mitigate disparities and optimal treatment must address aspects of both CMetS and mental health disorders in a culturally relevant intervention. The overall goal of this diversity supplement is to identify strategies to enhance the systems science map of the parent project by utilizing community survey data, and to guide the development of antiracism interventions and implementation strategies in the domain of comorbid mental health and cardiovascular/metabolic conditions. Training goals and Research Aims to address the overall objective are as follows: Training Goal 1 (TG1): Develop expertise in integrating “big data” and community-based studies for the identification of and social determinants for comorbid mental health and Cardiovascular/ Metabolic conditions Training Goal 2 (TG2): Gain mastery in the ORBIT model of intervention development to translate basic behavioral and social science into new antiracism interventions and implementation strategies to address triple complexities of social, behavioral, and clinical challenges. Training Goal 3 (TG3): Obtain training in computational simulation modeling (e.g systemic dynamic modeling) to study the effects of potential intervention strategies on a complex system (eg. Primary care) Primary Research Aim: Understand community member perspectives on barriers and facilitators to successful disease management of comorbid cardiometabolic and mental health conditions among underserved ethnic minorities in the Southern United States including antiracism and other social determinants of health. Research Aim 1a (RA1a). Use a community based participatory research (CBPR) approach to conduct focus groups to address community concerns and incorporate community perspectives into future large scale community survey development and design to guide the assessment process. Research Aim 1b (RA1b). Conduct a pilot community survey to identify barriers and facilitators to successful disease management of comorbid cardiovascular/metabolic and mental health conditions and to accessing health care services.

这种多样性补充剂将以我作为社会流行病学家的培训为基础 流行病学研究试图了解结果中的复杂驱动因素和分布机制 与合并的心脏代谢和心理健康状况，实施科学和社会有关 决定因素。心脏代谢综合征（CMETS）和动画非常普遍，管理复杂 彼此同时发生时彼此之间，导致更大的残疾和医疗保健利用和成本。如此多的 当合并症与种族不平等和社会决定者相交时，合并症变得更加具有挑战性 健康最终导致放大不良后果的风险。成功的疾病管理 必须实施个人和社区的交集，以减轻分布和最佳 治疗必须解决与文化相关的干预措施中CMET和心理健康障碍的各个方面。 这种多样性补充的总体目标是确定策略以增强系统科学图 父母项目通过使用社区调查数据，并指导抗逆性干预措施的发展和 合并症心理健康和心血管/代谢状况领域的实施策略。 培训目标和研究旨在解决总体目标如下： 培训目标1（TG1）：在整合“大数据”和基于社区的研究方面的专业知识 确定合并心理健康和心血管/代谢状况的社会决定者和社会决定者 培训目标2（TG2）：掌握干预开发的轨道模型以翻译基本 行为和社会科学作为新的反统治干预措施和实施策略，以解决三重 社会，行为和临床挑战的复杂性。 训练目标3（TG3）：获得计算模拟建模（例如系统动态建模）的培训 研究潜在干预策略对复杂系统的影响（例如，初级保健） 主要研究目的：了解成功的社区成员的观点 疾病的合并症心脏代谢和心理健康状况的疾病管理不足的族裔 美国南部的少数民族，包括反狂热和其他卫生社会决定者。 研究目标1A（RA1A）。使用基于社区的参与研究（CBPR）方法进行重点 解决社区关注并将社区观点纳入未来的大规模的小组 社区调查开发和设计以指导评估过程。 研究目标1B（RA1B）。进行试点社区调查，以确定成功的障碍和促进者 合并症心血管/代谢和心理健康状况的疾病管理以及进入 卫生保健服务。