Cardiometabolic Disease Prevention in College-based Young Adults: Mapping a Contextual Sedentary Behavior Intervention

大学年轻人的心脏代谢疾病预防：制定相关的久坐行为干预措施

• 批准号: 10625461
• 负责人: Erik D Hanson
• 金额: $ 51.95万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10625461
• 关键词: Accelerometer; Adopted; Adult; Arterial Fatty Streak; Behavior; Behavior Therapy; Biological Markers; Cardiometabolic Disease; Communities; Computers; Consultations; Development; Diet; Dietary Practices; Dimensions; Evaluation; Factor Analysis; Food; Future; General Population; Goals; Health; Health behavior; Hour; Individual; International; International Agencies; Intervention; Leisures; Life Style; Lipids; Longitudinal, observational study; Maps; Measures; Mediating; Mediation; Modeling; Occupational; Participant; Physical activity; Physical environment; Physiologic pulse; Population; Posture; Predictive Factor; Primary Prevention; Process; Protocols documentation; Public Health; Questionnaires; Recommendation; Recreation; Research; Risk Factors; Self Efficacy; Strenuous Exercise; Supination; Television; Thigh structure; Transportation; Visit; World Health Organization; Wrist; behavior prediction; cohort; college; design; disorder prevention; disorder risk; evidence base; experience; food consumption; human old age (65+); implementation intervention; innovation; intervention mapping; multidisciplinary; novel; recruit; sedentary lifestyle; sleep behavior; social norm; sociodemographic variables; substance use; therapy design; tv watching; young adult

ABSTRACT Among young adults (18-24 years), a concerning 10-20% develop advanced but asymptomatic atherosclerotic lesions, yet cardiometabolic disease (CMD) prevention is understudied. In the U.S. two-thirds of young adults attend college, during which they adopt poor lifestyle behaviors that contribute to CMD risk. For example, college-based young adults (CBYA) engage in sedentary behavior (SB), defined as very low intensity behaviors in a seated, reclined, or supine postures, for ~7 hr/day. National and international public health agencies have recently called on the research community to better understand how to implement SB-reduction strategies. However, while CBYA present a captive but understudied population, we have scant understanding as to how to target this multi-dimensional behavior. Our long-term goal is the primary prevention of CMD in CBYA. To support this goal, the overarching aim of this proposal is to develop an evidence-based, multi-level intervention to target SB reduction. This longitudinal observational study will recruit a cohort of 500 CBYA (18-24 years) from a representative state college population. On each of the two visits (12 months apart) we will measure traditional and novel CMD risk biomarkers and administer participant questionnaires to collect information on lifestyle behaviors (diet, chronotype, substance use) and socio-ecological (individual, intra-individual, inter-individual) predictors of SB. Over the next 7 days, SB quantity will be captured using a thigh-worn inclinometer, and physical activity and sleep behaviors using accelerometry. SB context (television, transportation, academic/occupational, leisure computer, other) will be measured using ecological momentary analysis. Aim 1 will identify whether total SB (T-SB) or context-specific SB (CS-SB) is more strongly associated with CMD risk. The degree to which SB confers CMD risk likely depends on the context in which it occurs. For example, in the general adult population, television viewing is more strongly associated with CMD than other CS-SB. The reasons are unknown but may include the greater likelihood of co-occurring unhealthy behaviors (e.g., processed foods) while watching television. Therefore, Aim 2 will identify how much CMD risk is explained directly by SB, versus indirectly mediated by co-occurring lifestyle behaviors. Aim 3 will then identify multi-level intervention targets. To date, the existing longitudinal research has predominantly focused on non-modifiable socio-demographic variables. We will use a socioecological model to identify modifiable predictors. Last, will use the Intervention Mapping protocol to design an intervention implementation and evaluation plan. This innovative proposal will enhance our understanding of the importance of CS-SB and co- occurring behaviors to CMD risk. The final product will be an evidence-based CS-SB reduction intervention to target primary CMD prevention in CBYA. The likelihood of future high impact is enhanced by: college campuses are relatively contained are well-suited to multi-level interventions; behaviors adopted during college track into older adulthood; and our experienced multi-disciplinary team.

抽象的 在年轻人（18-24 岁）中，约 10-20% 的人患有晚期但无症状的动脉粥样硬化 病变，但心脏代谢疾病（CMD）的预防尚未得到充分研究。在美国，三分之二的年轻人 上大学期间，他们采取了不良的生活方式，从而增加了 CMD 风险。例如， 大学年轻人 (CBYA) 从事久坐行为 (SB)，定义为非常低强度 每天约 7 小时以坐姿、斜倚或仰卧姿势进行行为。国家和国际公共卫生 各机构最近呼吁研究界更好地了解如何实施 SB 减少 策略。然而，虽然 CBYA 呈现出一个圈养但未被充分研究的群体，但我们对它知之甚少。 以及如何针对这种多维行为。我们的长期目标是 CMD 的一级预防 CBYA。为了支持这一目标，该提案的总体目标是制定一个基于证据的、 多层次干预以减少SB为目标。这项纵向观察研究将招募一组 500 CBYA (18-24 years) from a representative state college population.两次就诊（12 个月） 分开）我们将测量传统和新型 CMD 风险生物标志物，并对参与者进行问卷调查 收集有关生活方式行为（饮食、睡眠类型、物质使用）和社会生态（个人、 SB 的个体内、个体间）预测因子。在接下来的 7 天内，SB 数量将使用 大腿佩戴的倾斜计，以及使用加速度测量的身体活动和睡眠行为。 SB 环境（电视、 交通、学术/职业、休闲计算机、其他）将使用生态瞬时进行测量 分析。目标 1 将确定总体 SB (T-SB) 或特定情境 SB (CS-SB) 哪个更强 与 CMD 风险相关。 SB 赋予 CMD 风险的程度可能取决于它所处的环境 发生。例如，在一般成年人口中，看电视与 CMD 的相关性更强 比其他CS-SB。原因尚不清楚，但可能包括同时发生不健康状况的可能性更大 看电视时的行为（例如加工食品）。因此，目标 2 将确定 CMD 风险有多大 是由 SB 直接解释的，而不是由同时发生的生活方式行为间接介导的。然后目标 3 将 确定多层次的干预目标。迄今为止，现有的纵向研究主要集中在 不可改变的社会人口变量。我们将使用社会生态模型来识别可修改的 预测因子。最后，将使用干预映射协议来设计干预实施和 评估计划。这项创新提案将加深我们对 CS-SB 和合作的重要性的理解 发生 CMD 风险的行为。最终产品将是基于证据的 CS-SB 减少干预措施 CBYA 的目标是 CMD 初级预防。通过以下方式增强未来产生重大影响的可能性： 大学 校园相对封闭，非常适合多层次的干预；大学期间采取的行为 步入老年期；以及我们经验丰富的多学科团队。