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）和其他健康状况有很大影响。到目前为止，很少有研究已经检查了这些变量与西班牙裔CVD-最大和增长最快的少数民族人口在美国要充分了解CVD和其他健康问题在西班牙裔，探索这些协会的额外证据是必要的。拟议的研究将使用统一的概念框架，在一个特征良好的，社会经济和区域多样化的西班牙裔队列中，研究SES，社会文化和心理风险以及与代谢综合征（MS; CVD和II型糖尿病风险的综合标志物）和CVD患病率相关的保护因素之间的关联。该研究将在西班牙裔社区健康研究（HCHS）/拉丁裔研究（SOL）的参与者子样本中进行，这是一项关于多种健康状况及其风险因素的流行病学研究，特别强调CVD。HCHS/SOL将包括来自古巴、波多黎各、墨西哥和中南美洲的16，000人，他们是从美国四个实地中心（圣地亚哥、迈阿密、芝加哥、纽约/布朗克斯）招募的。HCHS/SOL包括全面的临床检查，但非常有限的社会经济，社会文化和心理措施。在拟议的研究中，5280名参与者（年龄在18-74岁之间;每个研究中心1320名）将在他们的HCHS/SOL基线临床检查的6个月内完成对这些因素的全面访谈评估。收集的数据将与拟议的行为途径（例如，饮食、体力活动和吸烟）、MS和基线HCHS/SOL检查期间收集的CVD。结构方程模型将用于检验理论驱动的假设，这些假设涉及社会经济、社会文化和心理社会因素、行为途径以及MS和CVD患病率之间的关联。多组分析将检查可能的西班牙裔亚组差异。拟议的研究将提供一个显着的补充父HCHS/SOL研究，以帮助实现检查不同的风险和保护因素在西班牙裔健康的目标，并将提供急需的信息SES的作用，社会文化和心理社会因素，可以指导未来的预防和干预工作为美国西班牙裔人口，并为不同的西班牙裔亚组。这项研究将利用HCHS/SOL现有的巨大资源和基础设施（例如，有效的招聘策略;数据收集方面的重大进展;大量的行为和临床数据点;多样化的研究人员专业知识），以成本效益高、效率高的方式实现拟议目标。此外，收集的数据将成为未来研究人员的重要资源，他们可以通过HCHS/SOL数据集解决未来西班牙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：人们对社会经济地位（例如，收入），压力，情绪，关系和文化影响西班牙裔人的健康。拟议的研究将研究这些变量如何影响在四个美国现场中心调查的不同代表性西班牙裔群体的心血管疾病和其他健康风险，从而提供有关美国人口中这一庞大且快速增长的部分健康的重要信息。(End摘要）

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)