Ancillary to HCHS/SOL: Sociocultural Factors and CVD risk/prevalence in Hispanics

描述(由申请人提供)： 社会经济、社会文化和心理社会因素对心血管疾病(CVD)和其他健康状况有重要影响。到目前为止，很少有研究研究这些变量与拉美裔人心血管疾病的关系。拉美裔人是美国最大、增长最快的少数民族人口。为了充分了解拉美裔人的心血管疾病和其他健康问题，需要更多的证据来探索这些联系。这项拟议的研究将使用统一的概念框架，在具有良好特征的、社会经济和地区多样化的西班牙裔队列中，检查与代谢综合征(MS；心血管疾病和II型糖尿病风险的综合标志)和心血管疾病患病率相关的社会经济和心理风险和保护因素之间的关系。这项研究将在西班牙裔社区健康研究(HCHS)/拉美裔研究(SOL)参与者的子样本中进行，这是一项关于多种健康状况及其风险因素流行率的流行病学研究，特别强调心血管疾病。HCHS/SOL将包括16,000名古巴人、波多黎各人、墨西哥人和中美洲/南美洲人，他们从四个美国外地中心(圣地亚哥、迈阿密、芝加哥、纽约/布朗克斯)招募。HCHS/SOL包括全面的临床检查，但非常有限的社会经济、社会文化和心理测量。在拟议的研究中，5280名参与者(年龄18-74岁，每个站点1320人)将在他们的HCHS/SOL基线临床考试的6个月内完成对这些因素的全面面试评估。然后，收集的数据将与建议的行为途径的测量(例如，饮食、体力活动和吸烟)、在基线HCHS/SOL检查期间收集的MS和CVD联系起来。结构方程模型将被用来检验理论驱动的假说，这些假说涉及社会经济、社会文化和心理社会因素、行为途径、多发性硬化症和心血管疾病患病率之间的关系。多组分析将检查西班牙裔亚组可能存在的差异。这项拟议的研究将是对母公司HCHS/SOL研究的重要补充，有助于实现检查西班牙裔健康中的各种风险和保护因素的目标，并将提供关于社会经济地位、社会文化和心理社会因素的作用的亟需信息，这些因素可以指导美国拉美裔人口和不同的拉美裔亚群未来的预防和干预努力。这项研究将利用HCHS/SOL现有的大量资源和基础设施(例如，有效的招聘战略；数据收集方面的重大进展；大量的行为和临床数据点；不同的研究人员专业知识)，以具有成本效益和效率的方式实现拟议的目标。此外，收集的数据将成为未来研究人员的重要资源，他们可以在未来通过HCHS/SOL数据集解决关于拉美裔健康中的心理社会因素的无数研究问题。公共卫生相关性：关于拉美裔美国人的社会经济地位(例如，收入)、压力、情绪、关系和文化如何影响健康，我们知之甚少。这项拟议的研究将研究这些变量如何影响在美国四个实地中心接受调查的不同代表性拉美裔群体中的心血管疾病和其他健康风险，从而提供关于这一庞大且快速增长的美国人口部分的健康状况的重要信息。(摘要结束)

DESCRIPTION (provided by applicant): Socieconomic, sociocultural, and psychosocial factors contribute significantly to cardiovascular disease (CVD) and other health conditions. To date, little research has examined these variables in relation to CVD in Hispanics--the largest and fastest growing ethnic minority population in the U.S. To fully understand CVD and other health issues in Hispanics, additional evidence exploring these associations is needed. The proposed research will examine associations among SES, sociocultural, and psychological risk and protective factors in relation to Metabolic Syndrome (MS; an integrated marker of CVD and Type II diabetes risk) and CVD prevalence in a well-characterized, socieconomically and regionally diverse Hispanic cohort, using a unified conceptual framework. The research will be conducted in a sub-sample of participants from the Hispanic Community Health Study (HCHS)/Study of Latinos (SOL), an epidemiologic study of the prevalence of multiple health conditions and their risk factors, with a special emphasis on CVD. The HCHS/SOL will include 16,000 persons of Cuban, Puerto Rican, Mexican, and Central/South American origin, recruited from four U.S. field centers (San Diego, Miami, Chicago, New York/The Bronx). The HCHS/SOL includes a comprehensive clinical exam, but very limited socioeconomic, sociocultural, and psychological measures. In the proposed research 5280 participants (aged 18-74; 1320 per site) will complete a comprehensive interview assessment of these factors, within 6-months of their HCHS/SOL baseline clinic exam. Collected data will then be linked with measures of proposed behavioral pathways (e.g., diet, physical activity, and smoking), the MS, and CVD collected during the baseline HCHS/SOL exam. Structural equation modeling will be used to test theoretically-driven hypotheses concerning associations among socioeconomic, sociocultural, and psychosocial factors, behavioral pathways, and MS and CVD prevalence. Multi-group analyses will examine possible Hispanic subgroup differences. The proposed study will provide a significant complement to the parent HCHS/SOL study, to help achieve the goal of examining varied risk and protective factors in Hispanic health and will provide much needed information on the role of SES, sociocultural and psychosocial factors that can guide future prevention and intervention efforts for the US Hispanic population, and for distinct Hispanic subgroups. The study will capitalize on the tremendous resources and infrastructure available to HCHS/SOL (e.g., effective recruitment strategies; significant progress in data collection; large array of behavioral and clinical data points; diverse investigator expertise) to carry out the proposed aims in a cost-effective, efficient manner. Moreover, the collected data will become a significant resource to future researchers who can address a myriad of research questions regarding psychosocial factors in Hispanic health via the HCHS/SOL dataset in the future. PUBLIC HEALTH RELEVANCE: Little is known about how socioeconomic status (e.g., income), stress, emotions, relationships, and culture affect health in Hispanics. The proposed research will examine how such variables affect CVD and other health risks in a diverse representative group of Hispanics surveyed at four US field centers, thus providing important information about the health of this large and fast growing segment of the US population. (End of Abstract)