Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 31, 2021
Date Accepted: Jun 8, 2021
Geospatial Analysis of Neighborhood Environmental Stress in Relation to Biological Markers of Cardiovascular Health and Health Behaviors in Women: Protocol for a Pilot Study
ABSTRACT
Background:
Innovative analyses of cardiovascular (CV) risk markers and health behaviors linked to neighborhood stressors are essential to further elucidate mechanisms by which adverse neighborhood social conditions lead to poor CV outcomes. We propose to objectively measure physical activity, sedentary behavior, and neighborhood stress through accelerometers, global positioning systems (GPS), and ecological momentary assessment (EMA) via smartphone applications, and link these to biological measures in a sample of White and African American women in Washington, D.C. neighborhoods.
Objective:
The primary aim of this study is to test the hypothesis that living in adverse neighborhood social conditions is associated with higher stress-related neural activity among 60 healthy women living in high/low SES Washington D.C. areas. Sub-aim 1 of this study is to test the hypothesis that the association is moderated by objectively measured physical activity (PA) via accelerometer. A secondary objective is to test the hypothesis that residing in adverse neighborhood social environment conditions is related to differences in vascular function. Sub-aim 2 of this study is to test the hypothesis that the association is moderated by objectively measured PA. The third aim of this study is to test the hypothesis that adverse neighborhood social environment conditions are related to differences in immune system activation.
Methods:
The proposed study will be cross-sectional with a sample of at least 60 women (30 healthy White females and 30 healthy Black females) from Wards 3 and 5 in Washington, D.C. A sample of the women (n=30) will be recruited from high income areas in Ward 3 from census tracts within a 15% of Ward 3’s range for median household income. The other participants (n=30) will be recruited from low-income areas in Wards 5 from census tracts within a 15% of Ward 5’s range for median household income. Finally, participants from the Wards 3 and 5 will be matched based on age, race, and body mass index (BMI). Participants will wear a GPS unit and accelerometer, and report on their stress and mood in real time using a smartphone. We will then examine associations between GPS-derived neighborhood variables, stress-related neural activity measures, and adverse biological markers.
Results:
The National Institutes of Health Institutional Review Board has approved this study. Recruitment will begin in summer of 2021.
Conclusions:
Findings from this research could inform the development of multi-level behavioral interventions and policies to better manage environmental factors that promote immune system activation or psychosocial stress while concurrently working to increase physical activity, reduce sedentary time, or improve dietary intake, thereby influencing CV health. Clinical Trial: ClinicalTrials.gov identifier NCT04014348
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