Positive Psychology Intervention for Spanish-speaking Hispanic/Latino Adults at Risk for Cardiovascular Disease

摘要：项目说明 美国西班牙裔/拉丁裔(H/L)人群的心血管疾病患病率高得不成比例 疾病(CVD)危险因素。建议设立K01导师职业发展奖，以提升教师 多样性将有助于Rosalba Hernandez博士建立具有以下专业知识的独立研究生涯 H/L心血管健康不良成人的治疗性心理社会干预。但是，成功了 获得独立调查员的地位需要进一步的培训。培训目标旨在 增加她在以下方面的专长：临床试验设计；随机试验的统计方法；生理学 脑-心相互作用机制与非侵入性心脏病学；积极心理学的传播 干预措施；以及研究传播和加强专业发展方面的高级技能。培训 充分利用候选人在伊利诺伊大学的强大机构支持和环境。 观察性研究表明，积极的心理健康(或 情绪健康)和心血管健康，但需要进行实验测试来评估 旨在改善心理健康的干预措施会增强心脏健康。这项建议 由两项相互关联的研究组成，共同探索心理健康和心脏健康之间的联系 健康，以及对生物行为机制的微妙探索。使用西班牙裔社区卫生数据 研究/研究拉丁裔(HCHS/SOL)(n=16,415)，我们将检查横断面和前瞻性 积极的情绪幸福感(例如，乐观)与心血管健康之间的联系， 探索可能的中介，如自主神经系统活动，炎性生物标志物， 和内皮功能。大而不同种类的六氯环己烷/SOL队列数据允许识别效果 原籍国和文化适应程度等修饰语，这在一国的背景下往往是不可行的 小型试验性试验。此外，我们还建议实施一项试验性的集群随机试验。总计 患有未控制高血压的成人H/L将参加一项试点整群随机试验 积极心理学(PP)干预的有效性。PP干预与注意控制的有效性比较 ARM将主要根据血压进行评估，其次是情绪健康和健康行为 依从性、心率变异性和C反应蛋白。 拟议的研究将提供初步数据，以进行更大的全功率随机对照试验 通过R01机制提供资金。赫尔南德斯博士将通过跨学科指导获得关键技能 来自心血管流行病学、非侵入性心脏病学和临床心理学的专家。经验 从拟议的K01相关活动中获得的收益将为Hernandez博士提供必要的能力来 成为一名成功的独立调查员。

Abstract: Project Description The Hispanic/Latino (H/L) population in the US has a disproportionately higher prevalence of cardiovascular disease (CVD) risk factors. The proposed K01 Mentored Career Development Award to Promote Faculty Diversity will facilitate Dr. Rosalba Hernandez in establishing an independent research career with expertise in therapeutic psychosocial interventions for H/L adults with poor cardiovascular health. But, successful attainment of status as an independent investigator requires further training. Training objectives aim to increase her expertise in: clinical trials design; statistical methodology for randomized trials; physiological mechanisms of the brain-heart interaction and non-invasive cardiology; delivery of positive psychology interventions; and advanced skills in research dissemination and enhanced professional development. Training takes full advantage of the candidate's strong institutional support and environment at the University of Illinois. Observational studies demonstrate a robust association between positive psychological well-being (or `emotional well-being') and cardiovascular health, but experimental testing is required to assess whether interventions geared toward improving psychological well-being result in enhanced heart health. This proposal consists of two interrelated studies that together explore the link between psychological well-being and cardiac- health, with nuanced exploration of biobehavioral mechanisms. Using data of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (n=16,415), we will examine the cross-sectional and prospective association between positive emotional well-being (e.g., optimism) and cardiovascular health, with in-depth exploration of plausible intermediaries such as autonomic nervous system activity, inflammatory biomarkers, and endothelial function. The large and heterogeneous HCHS/SOL cohort data allows identification of effect modifiers such as country of origin and level of acculturation, which is often not feasible in the context of a small experimental trial. We additionally propose implementation of a pilot cluster-randomized trial. A total of 126 H/L adults with uncontrolled hypertension will participate in a pilot cluster-randomized trial testing the efficacy of a positive psychology (PP) intervention. Efficacy of the PP intervention versus an attentional control arm will be assessed primarily for blood pressure, and secondarily for emotional well-being, health behavior adherence, heart rate variability, and C-reactive protein. The proposed studies will provide preliminary data to conduct a larger fully-powered RCT with pursuit of funding via an R01 mechanism. Dr. Hernandez will obtain critical skills through interdisciplinary mentorship from experts in cardiovascular epidemiology, non-invasive cardiology, and clinical psychology. Experiences gained from the proposed K01-related activities will provide the necessary competences for Dr. Hernandez to become a successful independent investigator.