"Youth Exposure to Violence and Pulmonary and Cardiovascular Health: Meta- and Primary-Analytic Approaches to Understanding Mediators and Moderators."

项目摘要 青年接触暴力是一个普遍存在的问题。从理论上讲，这些暴露会导致 随着时间的推移，通过影响已知有助于疾病的生物和行为过程而保持健康，包括 肺和心血管(CV)疾病。然而，对年轻人的持久影响进行的实证测试有限 接触暴力可能会对与疾病相关的临床风险及其进展产生影响。此外，还有 有限的机械论理解，尽管理论工作表明通过免疫力较差的途径 功能和健康行为。最后，暴力对肺部和心血管疾病的影响程度 不同研究的健康状况各不相同，合成效应的大小尚不清楚。然而，这种可变性指向了 可能增加易受暴力负面影响或保护青年免受暴力负面影响的潜在因素。 对潜在途径和调节因素的洞察有助于揭示 干预，针对可能处于最高风险的青年。因此，拟议的研究旨在确定(1) 综合效应大小和青年暴力暴露对肺部和心血管风险的纵向影响； (2)暴力活动的免疫和行为途径；(3)样本、效果和 个人级别的主持人，可能加剧或减轻暴力的影响。值得注意的是，拟议的 研究目标将被综合利用元分析方法来获取知识广度 和初级分析方法，以获得知识的深度。元分析方法将合成电流 估计青年接触暴力对肺和肺疾病影响程度的经验证据 CV健康，巩固现有研究，以测试综合间接影响和总体模型拟合 建议的途径，并探索样本(例如，人口构成)和影响(例如，暴力背景 暴露)特征作为潜在的主持人。作为补充，主要的分析方法将吸引 来自伊迪丝·陈博士资助的两项纵向研究，以检查青年暴露于 哮喘背景下的暴力和心血管疾病风险。具体来说，初步分析将检查纵向链接 从暴力到哮喘和心血管风险，通过深入探讨炎症过程和 评估医疗记录和活动记录数据，以及探索个人层面的缓冲作用 在减轻暴力影响方面的应对因素。获得关于青年的知识的广度和深度 暴露在暴力中不仅解决了公共卫生问题，执行拟议的研究还将 培养申请者成为进行初级和元分析的独立研究人员的目标 阐明健康差异背后的心理社会、生物和行为过程的研究。 具体地说，它将支持了解青年中的社会因素如何有助于健康的培训目标 差异，获得将社会结构与免疫联系起来的概念基础和实验室技能 过程，掌握先进的统计技术，并在这些领域建立出版记录。

Project Summary Youth exposure to violence is a pervasive issue. These exposures are theorized to give rise to disparities in health over time by impacting biological and behavioral processes known to contribute to diseases, including pulmonary and cardiovascular (CV) diseases. Yet, there is limited empirical test of the enduring effects youth exposure to violence may have on disease-relevant clinical risks and their progressions. Additionally, there is limited mechanistic understanding despite theoretical work suggesting pathways through poorer immune functioning and health behaviors. Finally, the magnitude of the impact violence has on pulmonary and CV health varies across studies and the synthesized effect size is still unknown. This variability, however, points to potential factors that may increase vulnerability to, or protect youth from, the negative impact of violence. Gaining insights about underlying pathways and moderating factors can help reveal promising points of intervention, targeting youth who may be most at-risk. Thus, the proposed research aims to identify (1) the synthesized effect size and the longitudinal impact of youth exposure to violence on pulmonary and CV risks; (2) the immune and behavioral pathways through which violence operates; (3) the sample-, effect-, and individual-level moderators that may exacerbate or mitigate the impact of violence. Notably, the proposed study aims will be addressed comprehensively utilizing meta-analytic approaches to gain breadth of knowledge and primary-analytic approaches to gain depth of knowledge. Meta-analytic approaches will synthesize current empirical evidence to estimate the magnitude of the impact youth exposure to violence has on pulmonary and CV health, consolidate existing research to test the synthesized indirect effects and overall model fit of the proposed pathways, and explore sample (e.g., demographic composition) and effect (e.g., context of violence exposure) characteristics as potential moderators. Complementarily, primary analytical approaches will draw from two of Dr. Edith Chen’s NIH-funded longitudinal studies to examine the impact of youth exposure to violence in the context of asthma and CV risks. Specifically, primary analyses will examine the longitudinal link from violence to asthma and CV risks, test mediators by probing in-depth inflammatory processes and assessing medical records and actigraphy data, as well as explore the buffering role of an individual-level coping factor in mitigating the impact of violence. Gaining breadth and depth of knowledge about youth exposure to violence not only addresses a public health concern, execution of the proposed research will also foster the applicant’s goal to be an independent researcher conducting both primary- and meta-analytic research that elucidates the psychosocial, biological, and behavioral processes underlying health disparities. Specifically, it will support the training goals of understanding how social factors in youth contribute to health disparities, acquiring conceptual foundation and laboratory skills for relating social constructs to immune processes, mastering advanced statistical techniques, and establishing a publication record in these areas.