底特律心脏研究：深入了解城市中老年人非裔美国人日常生活，以理解心血管疾病风险的心理社会决定因素。
The heart of Detroit study: a window into urban middle-aged and older African Americans' daily lives to understand psychosocial determinants of cardiovascular disease risk.
机构信息
Department of Psychology, Wayne State University, 5057 Woodward Avenue, Detroit, MI, 48202, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, 48824, USA.
出版信息
BMC Psychiatry. 2023 Oct 18;23(1):766. doi: 10.1186/s12888-023-05148-2.
BACKGROUND
Cardiovascular disease disproportionately affects African Americans. Psychosocial factors, including the experience of and emotional reactivity to racism and interpersonal stressors, contribute to the etiology and progression of cardiovascular disease through effects on health behaviors, stress-responsive neuroendocrine axes, and immune processes. The full pathway and complexities of these associations remain underexamined in African Americans. The Heart of Detroit Study aims to identify and model the biopsychosocial pathways that influence cardiovascular disease risk in a sample of urban middle-aged and older African American adults.
METHODS
The proposed sample will be composed of 500 African American adults between the ages of 55 and 75 from the Detroit urban area. This longitudinal study will consist of two waves of data collection, two years apart. Biomarkers of stress, inflammation, and cardiovascular surrogate endpoints (i.e., heart rate variability and blood pressure) will be collected at each wave. Ecological momentary assessments will characterize momentary and daily experiences of stress, affect, and health behaviors during the first wave. A proposed subsample of 60 individuals will also complete an in-depth qualitative interview to contextualize quantitative results. The central hypothesis of this project is that interpersonal stressors predict poor cardiovascular outcomes, cumulative physiological stress, poor sleep, and inflammation by altering daily affect, daily health behaviors, and daily physiological stress.
DISCUSSION
This study will provide insight into the biopsychosocial pathways through which experiences of stress and discrimination increase cardiovascular disease risk over micro and macro time scales among urban African American adults. Its discoveries will guide the design of future contextualized, time-sensitive, and culturally tailored behavioral interventions to reduce racial disparities in cardiovascular disease risk.
背景
心血管疾病在非裔美国人中发病率较高。心理社会因素，包括经历和对种族主义及人际压力源的情绪反应，通过对健康行为、应激反应神经内分泌轴和免疫过程的影响，促成了心血管疾病的病因和进展。这些关联的完整途径和复杂性在非裔美国人中仍未得到充分研究。“底特律之心研究”旨在确定并建模影响城市中年和老年非裔美国成年人心血管疾病风险的生物心理社会途径。
方法
拟议的样本将由底特律市区 500 名年龄在 55 至 75 岁之间的非裔美国成年人组成。这项纵向研究将包括两年一次的两个数据收集波次。每次波次都将采集应激、炎症和心血管替代终点（即心率变异性和血压）的生物标志物。在第一次波次中，生态瞬时评估将描述应激、情绪和健康行为的瞬时和日常体验。一个拟议的 60 人亚组还将完成深入的定性访谈，以背景化定量结果。该项目的核心假设是，人际压力源通过改变日常情绪、日常健康行为和日常生理应激，预测心血管不良结局、累积生理应激、睡眠质量差和炎症。
讨论
本研究将深入了解在微观和宏观时间尺度上，经历压力和歧视如何通过改变日常情绪、日常健康行为和日常生理应激，增加城市非裔美国成年人的心血管疾病风险的生物心理社会途径。其发现将指导未来基于情境、时间敏感和文化适应性的行为干预措施的设计，以减少心血管疾病风险方面的种族差异。
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