Determinants of Cardiac Risk Factor Modification

描述(由申请人提供)： 这一职业发展计划将通过提供教学课程作业、结构化指导和实践研究经验来培养申请者成为独立调查员的能力。这些课程将集中于提高研究方法、生物统计学和拨款撰写方面的技能。与导师的每周有组织的会议将集中于研究的进展、手稿的出版和赠款的提交。拟议的前瞻性队列研究将应用跨理论模型的结构，以确定在接受冠状动脉血管成形术的拉丁裔患者中参与体力活动的心理社会决定因素。具体来说，目标是：1)确定抑郁症状是否是两年后参加体育活动的预测因素；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会中介抑郁症状对体育活动的影响。这项研究建立在由少数民族调查者研究补充资料支持的血管成形术患者的初步数据基础上，该数据显示，在这项研究中，只有18%的拉丁裔人在进行体力活动。拉丁裔人也比非拉丁裔人有更多的抑郁症状，有抑郁症状的拉丁裔人在1岁时不太可能进行体育锻炼。这项拟议的研究建立在以前工作的基础上，使申请者能够继续进行一项研究轨迹，重点是确定患有冠状动脉疾病的少数群体行为变化的可修改决定因素。 在招募后一个月内接受血管成形术的总共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、心脏病危险因素、共病、抑郁症状(由流行病学研究中心测量)、社会支持、自我效能和感受到的压力。后续访谈将每6个月进行一次。结果衡量标准是积极参与体育活动，每周至少有4天进行30分钟的适度活动。根据跨理论模型的变化阶段结构，在这个水平上处于体力活动的行动或维持阶段的参与者将被归类为活跃在体力活动中的参与者。长期目标是利用这些数据开发干预措施，改善患有冠状动脉疾病的拉丁裔成年人的体力活动。

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.