The objective of this F32 award is to provide research training that will allow the applicant to become a productive, independent investigator in the fiel of cardiovascular health and related risk factors. With a strategic training plan that combines research experience, coursework, and guided mentorship, the applicant will develop the skills and experience necessary for establishing an independent research career. This proposal will examine the multilevel nature of cardiovascular health risks and outcomes. That is, both the characteristics of individuals and attributes of the neighborhood environments in which they live concurrently influence health and health-related behaviors. Acknowledging this environmental/individual interaction is particularly relevant to interventions that focus on modifying the health behaviors of individuals. While individually-focused interventions are useful in addressing health behaviors related to diet modification or physical activity, such intervention most often do not account for the influence of the neighborhood environment on such behaviors. This research proposal has 2 aims: 1) to examine if the neighborhood environment moderates the effect of an intervention on change in cardiovascular health factors and behaviors in individuals who participated in a randomized control trial (RCT) study and 2) to examine if the neighborhood environment differentially moderates the effect of an intervention on change in cardiovascular health factors and behaviors between African American and white participants who participated in RCT study. Data from an NIH-funded and an AHA-funded study will be linked to test the hypotheses that: 1) Features of an unhealthy contextual environment (i.e., poor social environment, lack of opportunities for physical activity, and food availability that encourages unhealthy dietary practices) will significantly moderate the effect of an exercise intervention on change in indicators of cardiovascular health and will inhibit decreases in 1) weight, 2) energy intake, 3) total cholesterol, 4) blood pressure, 5) glucose, 6) waist circumference, 7) low-density lipoprotein (LDL), 8) triglycerides, and 9) total body fat; and will inhibit increases in 10) physical activity and 11) high- density lipoprotein (HDL); and 2) African American participants will demonstrate significantly weaker change in indicators of cardiovascular health in response to an exercise intervention due to the differential moderating influence of features of an unhealthy neighborhood environment. Findings from the proposed study will provide novel evidence that can be used in the development of more efficacious interventions that aim to improve cardiovascular health. In carrying out the aims of this research proposal, the applicant will develop 1) conceptual and analytical skills related to multilevel determinants of cardiovascular health and 2) clinical-based research skills related to randomize controlled intervention trials. These skills are crucial for the applicant to successfully initiatean independent, productive research career that will focus on cardiovascular health.
Cardiovascular disease is the leading cause of death in the United States. The relevance of the proposed work is demonstrated in the use of findings to develop more effective interventions that utilize multilevel approaches to treat and prevent chronic disease and related risk factors in individuals. This objective is explicitly identified bythe Healthy People 2020 Framework.
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