Examining How Psychosocial Stress Gets "Under the Skin" and Leads to Cardiovascular Disease Risk in Diverse Children: A Mixed-Methods Study

检查心理社会压力如何“深入皮肤”并导致不同儿童的心血管疾病风险：一项混合方法研究

• 批准号: 10753049
• 负责人: Jerica M Berge
• 金额: $ 1.78万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10753049
• 关键词: Accelerometer; Adolescence; Adolescent; Adult; Affect; African American; Age; American; American Psychological Association; Behavioral; Biological; Biological Factors; Biological Markers; Blood Pressure; Body Composition; Body mass index; COVID-19; Cardiovascular Diseases; Child; Child Behavior; Child Health; Child Rearing; Childhood; Cohort Studies; Data; Data Collection; Development; Diet; Dimensions; Disadvantaged; Disease; Disparity; Ecological momentary assessment; Epidemiology; Ethnic Origin; Ethnic Population; Exposure to; Family; Family Life Cycle; Field Reports; Focus Groups; Frequencies; Hair; Heart Rate; Hispanic; Household; Hydrocortisone; Immigrant; Individual; Interruption; Intervention; Journals; Lead; Life Cycle Stages; Measures; Methods; Minority Groups; Native Americans; Neighborhoods; Obesity; Parents; Pathway interactions; Phase; Politics; Process; Psychosocial Stress; Puberty; Public Health; Race; Refugees; Reporting; Research Personnel; Role; Severities; Skin; Stress; Structural Racism; Surveys; Time; United States National Institutes of Health; Weight; arterial stiffness; cardiovascular disorder risk; design; dietary; early experience; experience; feeding; follow-up; high risk; human centered design; hypothalamic-pituitary-adrenal axis; improved; indexing; innovation; middle childhood; novel; obesity in children; obesity risk; prospective; psychosocial stressors; racial disparity; racial health disparity; racial population; resilience; retention rate; risk mitigation; waist circumference

ABSTRACT Recent reports from the American Journal of Public Health and the American Psychological Association identified a critical need to examine mechanisms by which exposure to psychosocial stress in childhood increases the risk for obesity and cardiovascular disease (CVD) in adulthood. Given there is a lag in time before the impact of psychosocial stress experienced in childhood is expressed as disease in adulthood, these calls-to-action urge researchers to investigate the role of modifiable factors over the course of childhood that may mitigate risk for later obesity and CVD. The proposed mixed-methods study is uniquely designed to answer these calls-to-action by examining how stress “gets under the skin” to put children at higher risk for later obesity and CVD, and ultimately health disparities by race/ethnicity. The main objectives of this study are to: (1) comprehensively examine the relationships between multi-level psychosocial stressors (i.e., individual, dyadic, household, societal) and their dimensions (i.e., severity, frequency, timing), biological factors (e.g., hypothalamic pituitary adrenal (HPA) axis activity), and child weight and emerging CVD risk over the course of childhood and (2) identify modifiable factors at the individual, parental, and familial level to interrupt these stress pathways. The proposed study will build on and expand a prior parent R01 study (HL126171). The parent R01 study is a two-phased, mixed-methods study including a prospective epidemiological cohort study with 1307 diverse parent/child (ages 5-16) dyads (≈200 each African American, Hispanic, Native American, Immigrant/Refugee, White) and an embedded ecological momentary assessment (EMA) sub-sample with 627 parent/child dyads (≈100 per each racial/ethnic group). Data was collected at two time points (baseline, 24-month follow-up). In the proposed study, online survey data and 7-day EMA data will be continued at 48 and 72 months, allowing for a total of four waves of data collection. Children, who are now ages 9-16 will be added to both the online survey and EMA data collection, in addition to participating in three 24 hr. dietary recalls and 7-day accelerometry. New biological measures (e.g., hair cortisol, body composition, arterial stiffness) with children and parents, neighborhood factors (e.g., child opportunity and disadvantage index) using geo-spatial measures, and societal-level factors (e.g., structural racism, sociopolitical shift, COVID-19) contributing to psychosocial stressors will also be added at both time points. Human-Centered Design multi-family focus groups will also be carried out to co-create intervention targets with families. This study will provide breadth and depth in understanding the pathways between multi-level psychosocial stressors and child weight and emerging CVD across important developmental milestones (e.g., puberty) and family life cycle stages (e.g., families with young children to families with adolescents). Importantly, this study will identify modifiable factors (e.g., family adaptability/resilience) that mitigate the negative impact of multi-level psychosocial stressors on child CVD that can be targeted in interventions.

抽象的 美国公共卫生杂志和美国心理学会的最新报告 确定了迫切需要检查儿童时期遭受社会心理压力的机制 增加成年后肥胖和心血管疾病（CVD）的风险。鉴于存在时间滞后 在童年经历的社会心理压力的影响在成年后表现为疾病之前，这些 号召性用语敦促研究人员调查可改变因素在童年过程中的作用 可以降低以后肥胖和心血管疾病的风险。拟议的混合方法研究的独特设计是为了 通过检查压力如何“深入皮肤”来回应这些号召性用语，从而使孩子处于更高的水平 日后肥胖和心血管疾病的风险，以及最终因种族/民族而产生的健康差异。主要目标 本研究的目的是：（1）全面考察多层次心理社会压力源之间的关系 （即个人、二元、家庭、社会）及其维度（即严重性、频率、时间）、生物学 因素（例如下丘脑垂体肾上腺 (HPA) 轴活动）、儿童体重和新出现的 CVD 风险 (2) 确定个人、父母和家庭层面上可改变的因素 中断这些压力途径。拟议的研究将建立在先前的母体 R01 研究的基础上并对其进行扩展 （HL126171）。母公司 R01 研究是一项两阶段的混合方法研究，包括一项前瞻性研究 流行病学队列研究，涉及 1307 名不同的父母/儿童（5-16 岁）二人组（每人约 200 名非洲裔美国人， 西班牙裔、美洲原住民、移民/难民、白人）和嵌入式生态瞬时评估 (EMA) 子样本，包含 627 个父母/子女二元组（每个种族/民族约 100 个）。数据收集于两点 时间点（基线、24 个月随访）。在拟议的研究中，在线调查数据和 7 天 EMA 数据将 持续 48 个月和 72 个月，总共可收集四波数据。孩子们，现在 除了参与三个活动外，9-16 岁的儿童还将被添加到在线调查和 EMA 数据收集中 24 小时。饮食回忆和 7 天加速测量。新的生物测量（例如头发皮质醇、身体成分、 动脉硬化）与儿童和父母、邻里因素（例如儿童的机会和劣势） 指数）使用地理空间措施和社会层面的因素（例如结构性种族主义、社会政治转变、 COVID-19）也会在两个时间点添加造成社会心理压力的因素。以人为本 还将设计多家庭焦点小组，与家庭共同制定干预目标。这 研究将为理解多层次心理社会之间的途径提供广度和深度 压力源和儿童体重以及重要发育里程碑中出现的心血管疾病（例如， 青春期）和家庭生命周期阶段（例如，有幼儿的家庭到有青少年的家庭）。 重要的是，这项研究将确定可改变的因素（例如，家庭适应性/复原力），以减轻 多层次心理社会压力源对儿童心血管疾病的负面影响，可以作为干预措施的目标。