FAITH! Heart Health+ 研究的基本原理、设计和参与者特征:探讨健康的社会决定因素、压力和结构性种族主义对非裔美国人心血管健康的影响。
Rationale, design, and participant characteristics of the FAITH! Heart Health+ study: An exploration of the influence of the social determinants of health, stress, and structural racism on African American cardiovascular health.
机构信息
Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
Hue-Man Partnership, 2400 Park Ave, Minneapolis, MN 55404, USA.
出版信息
Contemp Clin Trials. 2024 Aug;143:107600. doi: 10.1016/j.cct.2024.107600. Epub 2024 Jun 6.
BACKGROUND
African Americans (AAs) face cardiovascular health (CVH) disparities linked to systemic racism. The 2020 police killing of Mr. George Floyd in Minneapolis, Minnesota, alongside the COVID-19 pandemic, exacerbated adverse psychosocial factors affecting CVH outcomes among AAs. This manuscript describes the study protocol and participant characteristics in an ancillary study exploring the relationship between biopsychosocial factors and CVH among AAs.
METHODS
Using a community-based participatory approach, a mixed-methods ancillary study of 58 AA participants from an overarching randomized control trial (RCT) was conducted. Baseline RCT health assessments (November 2020) provided sociodemographic, medical, and clinical data. Subsequent health assessments (February-December 2022) measured sleep quality, psychosocial factors (e.g., high-effort coping), biomarkers (e.g., cortisol), and cardiovascular diagnostics (e.g., cardio-ankle vascular index). CVH was assessed using the American Heart Association Life's Simple 7 (LS7) (range 0 to 14, poor to ideal) and Life's Essential 8 (LE8) scores (range 0 to 100, low to high). Correlations between these scores will be examined. Focus group discussions via videoconferencing (March to April 2022) assessed psychosocial and structural barriers, along with the impact of COVID-19 and George Floyd's killing on daily life.
RESULTS
Participants were predominantly female (67%), with a mean age of 54.6 [11.9] years, high cardiometabolic risk (93% had overweight/obesity and 70% hypertension), and moderate LE8 scores (mean 57.4, SD 11.5).
CONCLUSION
This study will enhance understanding of the associations between biopsychosocial factors and CVH among AAs in Minnesota. Findings may inform risk estimation, patient care, and healthcare policies to address CVD disparities in marginalized populations.
背景
非裔美国人(AA)面临与系统性种族主义相关的心血管健康(CVH)差异。2020 年,明尼苏达州明尼阿波利斯市的乔治·弗洛伊德先生被警察杀害,以及 COVID-19 大流行,加剧了影响 AA 人群 CVH 结果的不利社会心理因素。本文描述了一项辅助研究的研究方案和参与者特征,该研究旨在探索 AA 人群中生物心理社会因素与 CVH 之间的关系。
方法
采用社区为基础的参与式方法,对来自一项总体随机对照试验(RCT)的 58 名 AA 参与者进行了一项混合方法的辅助研究。RCT 的基线健康评估(2020 年 11 月)提供了社会人口统计学、医学和临床数据。随后的健康评估(2022 年 2 月至 12 月)测量了睡眠质量、社会心理因素(如高努力应对)、生物标志物(如皮质醇)和心血管诊断(如心血管踝血管指数)。使用美国心脏协会的生命简单 7(LS7)(范围 0 至 14,差至理想)和生命基本 8(LE8)评分(范围 0 至 100,低至高)评估 CVH。将检查这些评分之间的相关性。通过视频会议进行的焦点小组讨论(2022 年 3 月至 4 月)评估了社会心理和结构障碍,以及 COVID-19 和乔治·弗洛伊德之死对日常生活的影响。
结果
参与者主要为女性(67%),平均年龄为 54.6[11.9]岁,心血管代谢风险高(93%超重/肥胖,70%高血压),LE8 评分中等(平均 57.4,SD 11.5)。
结论
本研究将提高对明尼苏达州 AA 人群中生物心理社会因素与 CVH 之间关联的理解。研究结果可能为风险评估、患者护理和医疗保健政策提供信息,以解决边缘化人群中的心血管疾病差异。