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.

这种多样性补充将建立在我作为一个社会流行病学家的训练，连接点之间的 流行病学研究，旨在了解结果差异的复杂驱动因素和机制 与共病的心脏代谢和精神健康状况有关，实施科学和社会 决定因素心脏代谢综合征（CMetS）和焦虑是非常普遍和复杂的管理 当它们同时发生时，会相互影响，导致更大的残疾和医疗保健利用率和成本。如此多- 当它与种族不平等和社会决定因素交织在一起时，科摩罗变得更具挑战性。 最终导致不良后果的风险增大。成功的疾病管理， 必须实现个人和社区的交叉，以减轻差距， 治疗必须在文化相关的干预中解决CMetS和精神健康障碍的各个方面。 这一多样性补充的总体目标是确定战略，以加强系统科学地图的 利用社区调查数据，指导反种族主义干预措施的制定， 在共病心理健康和心血管/代谢疾病领域的实施战略。 实现总体目标的培训目标和研究目标如下： 培训目标1（TG 1）：发展整合“大数据”和社区研究的专门知识， 共病精神健康和心血管/代谢疾病的识别和社会决定因素 培训目标2（TG 2）：掌握干预发展的ORBIT模型， 将行为和社会科学纳入新的反种族主义干预措施和执行战略， 社会、行为和临床挑战的复杂性。 培训目标3（TG 3）：获得计算仿真建模（例如系统动态建模）方面的培训， 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：了解社区成员对成功障碍和促进因素的看法 医疗服务水平低下的少数民族中心脏代谢和精神健康共病的疾病管理 美国南部的少数民族，包括反种族主义和其他健康的社会决定因素。 研究目标1a（RA 1a）。使用基于社区的参与式研究（CBPR）方法进行重点研究 团体，以解决社区关注的问题，并将社区观点纳入未来的大型 社区调查的发展和设计，以指导评估过程。 研究目标1b（RA 1b）。开展一项试点社区调查，以确定成功实施的障碍和促进因素 共病心血管/代谢和精神健康状况的疾病管理， 医疗保健服务。