Determinants and Consequences of Second-hand Smoke Exposure in African American

据推测，改善健康差距的最有效战略之一是减少非裔美国儿童(AA)及其父母的烟草暴露。暴露于非自愿二手烟的有害影响仍然是一个重大的公共健康危害；特别是对我们社会中最脆弱的人--儿童来说。基于人群的调查表明，大约50%的儿童暴露在二手烟(SHS)中；再障儿童表现出最高的SHS发生率 曝光。儿童暴露于SHS的高比率尤其令人担忧，因为与吸烟有关的疾病，如哮喘、高血压、糖尿病和心血管疾病的一生都始于儿童时期。我们预计，生活在MSM CEHD计划目标的以低收入为主的AA伴侣社区的儿童特别容易受到这种毒素的影响。然而，再生障碍性贫血儿童暴露于SHS的原因和病理生物学后果仍不清楚。这 该项目将首次深入描述SHS暴露对再生障碍性贫血儿童心血管、代谢和肺健康的社会决定因素和影响。这些研究将提供新的见解，指导制定更有效的干预措施，以防止AA家庭的烟草暴露。 我们的方法利用了儿童SHS暴露的社会生态模型，该模型假定儿童的邻里特征、家庭背景和个人生物因素之间存在多层次的相互作用。 我们的工作假设是，建筑环境中的某些因素使再生障碍性贫血儿童容易受到更多的非自愿烟草暴露(例如，烟草销售网点密度高；住房拥挤 条件)。其次，我们假设父母通过以下方式来决定儿童的SHS暴露：1)父母风险 2)父母的健康素养，3)影响儿童SHS暴露的父母心理社会因素(感知压力；社会支持)。该项目的具体目标是： 目的1：明确非裔美国儿童与高二手烟暴露相关的邻里特征、心理社会因素和父母行为。 目的2：明确儿童时期二手烟暴露与血管功能障碍的关系，血管功能障碍是心脏代谢性疾病的临床前标志。 目的3：开发一种预测模型，以识别处于SHS暴露高危状态的脆弱儿童。

It is postulated that one of the most effective strategies to ameliorate health disparities is to reduce tobacco exposure among African-American (AA) children and their parents. Exposure to the deleterious effects of involuntary secondhand smoking remains a major public health hazard; particularly for the most vulnerable in our society ~ children. Population-based surveys indicate that approximately 50% of children manifest exposure to secondhand smoke (SHS); and that AA children exhibit the highest rates of SHS exposure. The high rate of SHS exposure in children is particularly alarming because the life-course of smoking-related diseases such as asthma, hypertension, diabetes and cardiovascular disease have their onset during childhood. We anticipate that children living in the predominately low-income, AA partner community targeted by this MSM CEHD Program are particularly vulnerable to this toxin exposure. However, the causes and pathobiological consequences of SHS exposure in AA children remain poorly defined. This project will provide the first in-depth characterization of the social determinants and effects of SHS exposure on cardiovascular, metabolic and pulmonary health in AA children. These studies will provide new insights that will guide the development of more effective interventions to prevent tobacco exposure in AA families. Our approach utilizes a socio-ecological model of childhood SHS exposure that posits a multi-level interplay between the child's neighborhood characteristics, family context and individual biological factors. Our working hypothesis poses that certain elements in the 'built environment' predispose AA children to increased involuntary tobacco exposure (e.g. high density of tobacco marketing outlets; crowded housing conditions). Secondly, we hypothesize that parents determine childhood SHS exposure by: 1) parent risk behaviors (e.g. parent tobacco smoking), 2) parent health literacy and 3) parent psychosocial factors that influence childhood SHS exposure (perceived stress; social support). The project's specific aims are: Aim 1: Define the neighborhood characteristics, psychosocial factors and parenting behaviors associated with high secondhand smoke exposure in African-American children. Aim 2: Define the relationship between secondhand smoke exposure during childhood and vascular dysfunction, a pre-clinical marker of cardio-metabolic disease. Aim 3: Develop a predictive model to identify vulnerable children at high-risk for SHS exposure.