Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA.
Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
BMC Womens Health. 2024 Jul 5;24(1):391. doi: 10.1186/s12905-024-03182-0.
BACKGROUND: The racial/ethnic and gender disparities in cardiovascular disease (CVD) morbidity and mortality in the United States are evident. Across nearly every metric, non-Hispanic Black women have poorer overall cardiovascular health. Emerging evidence shows a disproportionately high burden of increased CVD risk factors in Black women of childbearing age, which has a far-reaching impact on both maternal and child outcomes, resulting in premature onset of CVD and further widens the racial disparities in CVD. There is growing recognition that the fundamental driver of persistent racial/ethnic disparities in CVD, as well as disparities in behavioral risk factors such as physical activity and sleep, is structural racism. Further, the lived personal experience of racial discrimination not only has a negative impact on health behaviors, but also links to various physiological pathways to CVD risks, such as internalized stress resulting in a pro-inflammatory state. Limited research, however, has examined the interaction between daily experience and health behaviors, which are influenced by upstream social determinants of health, and the downstream effect on biological/physiological indicators of cardiovascular health in non-pregnant Black women of childbearing age. METHODS/DESIGN: The BLOOM Study is an observational study that combines real-time ambulatory assessments over a 10-day monitoring period with in-depth cross-sectional lab-based physiological and biological assessments. We will use a wrist-worn actigraphy device to capture 24-h movement behaviors and electronic ecological momentary assessment to capture perceived discrimination, microaggression, and stress. Blood pressure will be captured continuously through a wristband. Saliva samples will be self-collected to assess cortisol level as a biomarker of psychological stress. Lab assessments include a fasting venous blood sample, and assessment of various indices of peripheral and cerebral vascular function/health. Participants' address or primary residence will be used to obtain neighborhood-level built environmental and social environmental characteristics. We plan to enroll 80 healthy Black women who are between 18 and 49 years old for this study. DISCUSSION: Results from this study will inform the development of multilevel (i.e., individual, interpersonal, and social-environmental levels) lifestyle interventions tailored to Black women based on their lived experiences with the goal of reducing CVD risk. GOV IDENTIFIER: NCT06150989.
背景:美国心血管疾病(CVD)发病率和死亡率的种族/民族和性别差异是明显的。在几乎所有指标上,非西班牙裔黑人女性的整体心血管健康状况都较差。新出现的证据表明,生育年龄的黑人女性中,心血管疾病风险因素的负担不成比例地增加,这对母婴结局都有深远的影响,导致 CVD 的发病提前,并进一步扩大 CVD 的种族差异。人们越来越认识到,持续存在的 CVD 种族/民族差异以及体力活动和睡眠等行为风险因素的差异的根本驱动因素是结构性种族主义。此外,经历种族歧视不仅对健康行为产生负面影响,而且还与 CVD 风险的各种生理途径相关联,例如导致促炎状态的内化压力。然而,有限的研究检查了日常经历和健康行为之间的相互作用,这些行为受到健康的社会决定因素的影响,并对生育年龄的非怀孕黑人女性的心血管健康的生物学/生理学指标产生下游影响。
方法/设计:BLOOM 研究是一项观察性研究,它将 10 天监测期内的实时动态评估与深入的横截面实验室生理和生物学评估相结合。我们将使用腕戴式活动记录仪设备来捕获 24 小时运动行为,并用电子生态瞬间评估来捕获感知歧视、微侵略和压力。通过腕带连续监测血压。通过自我采集唾液样本来评估皮质醇水平作为心理压力的生物标志物。实验室评估包括空腹静脉血样,以及评估外周和脑血管功能/健康的各种指标。参与者的地址或主要居住地将用于获取邻里级别的建筑环境和社会环境特征。我们计划为这项研究招募 80 名年龄在 18 至 49 岁之间的健康黑人女性。
讨论:这项研究的结果将为基于黑人女性生活经历的多层面(即个体、人际和社会环境层面)生活方式干预措施的制定提供信息,目的是降低 CVD 风险。
政府标识符:NCT06150989。
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