Determinants of Cardiac Risk Factor Modification

描述（由申请人提供）： 该职业发展计划将通过提供教学课程，结构化指导和实践研究经验，培养申请人成为独立调查员的能力。这些课程将侧重于提高研究方法，生物统计学和赠款写作的技能。与导师每周举行一次有组织的会议，重点讨论研究进展、手稿出版和赠款提交。拟议的前瞻性队列研究将应用跨理论模型的结构，以确定拉丁美洲患者谁有冠状动脉血管成形术参与体力活动的心理社会因素。具体来说，目标是：1）确定更多的抑郁症状是否是两年时参与体育活动的预测因子; 2）确定较低的社会支持、较低的自我效能感和较大的感知压力是否介导了抑郁症状对体育活动的影响。这项研究建立在少数民族研究者研究补充支持的血管成形术患者的初步数据基础上，该数据显示，在基线时，这项研究中只有18%的拉丁美洲人进行体力活动。拉丁美洲人也比非拉丁美洲人有更多的抑郁症状，有抑郁症状的拉丁美洲人在1岁时不太可能进行体力活动。拟议的研究建立在以前的工作基础上，使申请人能够继续研究轨迹，重点是确定少数冠状动脉疾病人群行为变化的可修改决定因素。 招募后一个月内接受血管成形术的213名拉丁裔患者将完成 标准化问卷评估人口统计学、文化适应、心脏危险因素、合并症、由流行病学研究中心抑郁量表测量的抑郁症状、社会支持、自我效能和感知压力。后续访谈将每6个月进行一次。结果指标是每周至少4天积极参与30分钟中等活动的体力活动。根据跨理论模型的变化阶段结构，处于该水平身体活动的行动或维持阶段的参与者将被归类为积极参与身体活动。长期目标是利用这些数据制定干预措施，改善患有冠状动脉疾病的拉丁美洲成年人的身体活动。

DESCRIPTION (provided by applicant): This career development program will foster the applicant's ability to become an independent investigator by providing didactic course work, structured mentorship, and hands-on research experience. The courses will focus on enhancing skills in research methodology, biostatistics, and grant writing. Structured weekly meetings with the mentor will focus on the progress of the study, publication of manuscripts, and submission of grants. The proposed prospective cohort study will apply constructs from the Transtheoretical Model to identify psychosocial determinants of participation in physical activity among Latino patients who have had coronary artery angioplasty. Specifically, the objectives are: 1) to determine whether more depressive symptoms is a predictor of participation in physical activity at two years and 2) to determine whether lower social support, lower self-efficacy, and greater perceived stress mediate the effects of depressive symptoms on physical activity. This study builds upon preliminary data from angioplasty patients supported by a Minority Investigator Research Supplement, which showed that at baseline only 18% of Latinos in this study were physically active. Latinos also had more depressive symptoms than non-Latinos and Latinos who had depressive symptoms were less likely to be physically active at 1 year. The proposed study builds upon previous work and enables the applicant to continue a research trajectory that focuses on identifying modifiable determinants of behavior change among minority populations with coronary artery disease. A total of 213 Latino patients who had angioplasty within one month of recruitment will complete standardized questionnaires assessing demographics, acculturation, cardiac risk factors, comorbidity, depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale, social support, self-efficacy, and perceived stress. Follow-up interviews will occur every 6 months. The outcome measure is active participation in physical activity at a level of 30 minutes of moderate activity on at least 4 days of the week. Based on the stages of change construct of the Transtheoretical Model, participants who are in the action or maintenance stage of physical activity at this level will be classified as being active in physical activity. The long-term goal is to use this data to develop interventions that improve physical activity among Latino adults with coronary artery disease.