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Externally Funded Research
Stress and Cardiovascular Risk Among Urban African American adults: A Multilevel, Mixed Methods Approach
- Funding Agency: National Institutes of Health – National Heart, Lung, and Blood Institute
- PNWU Researchers: Drs. Malcolm Cutchin and Heather Fritz, School of Occupational Therapy (subawardee)
- Collaborators: Dr. Samuele Zilioli (PI) at Wayne State University (prime awardee)
- Award Amount: $3,590,488 for 5 years ($176,024 awarded to PNWU)
- Award #: 1R01HL153377
- Project Summary: Despite the steady decline in cardiovascular diseases (CVD) morbidity and mortality in the US in the last few decades, African American (AA) adults bear a disproportionate share of cardiovascular disease (CVD) burden. Psychosocial factors—including neighborhood adversity, daily interpersonal stressors (i.e., racial discrimination, social isolation, negative interactions with others), and emotional reactivity to these stressors—are believed to contribute to the etiology and progression of CVD through their effects on health behaviors, the stress-responsive neuroendocrine axes, and immune processes. These factors are particularly salient for urban-dwelling middle-aged and older AAs, who experience unique stressors (e.g., residential segregation, racial discrimination, prejudice) and are more likely to live in situations of socioeconomic disadvantage than Whites. However, psychosocial factors and their link to CVD risk, and inflammation more broadly, have been remarkably understudied among AA adults. A fine-grained characterization of the daily stressors, health behaviors, and emotional responses related to CVD—and understanding of the situational contexts in which those occur—will significantly advance the science of CVD risk. Accordingly, the purpose of the proposed project is to identify and conceptualize—through a mixed-method approach—the psychosocial stressors most salient for this population and to model the daily psychological, behavioral, and biological pathways through which these factors may exacerbate CVD risk among middle-aged and older AAs. By adopting a prospective (two waves over two years) and multiple-time-scale design (daily assessments nested within waves), we will test this idea in a sample of 500 asymptomatic AAs aged 55-75 years living in Detroit. We will also use semi-structured interviews to collect qualitative data from 60 participants to contextualize the quantitative results. Our central hypothesis is that interpersonal stressors will predict decreases in resting heart rate variability and increases in resting blood pressure, poor sleep, chronic physiological stress (hair cortisol), and inflammation (basal and stimulated cytokines and basal CRP) by altering daily affect, daily health behaviors, and daily physiological stress (salivary cortisol). We propose to increase the innovation of our work by (1) using a smartphone-based ecological momentary assessment protocol to measure psychosocial stress, (2) including a sequential explanatory mixed-method design, (3) adopting a multiple-time-scale research design and a standardized measure of neighborhood deprivation created ad hoc for Detroit, and (4) simultaneously considering multiple measures of physiological stress, inflammation, and surrogate endpoints of CVD. The rationale for the proposed research is that once a clear picture of the daily psychosocial risk factors for CVD is formulated, and their biological intermediaries are identified, more culturally and individually tailored treatments can be developed to reduce CVD in this population.
African American Resilience in Surviving Cancer (ARISE)
- Funding Agency: National Institutes of Health – National Cancer Institute
- PNWU Researcher: Dr. Malcolm Cutchin, School of Occupational Therapy (sub-awardee)
- Collaborators: Dr. Felicity Harper (PI) at Wayne State University (prime awardee)
- Award Amount: $3,118,474 for 5 years ($83,462 awarded to PNWU)
- Award #: 5R01CA232514
- Project Summary: Substantial racial disparities exist in the health-related quality of life (HRQOL) and mortality of African American (AfAm) relative to Non-Hispanic White (NHW) cancer survivors. The premise of this study is that community, interpersonal, and individual influences combine to negatively affect the HRQOL of AfAm cancer survivors and are, thus, responsible for health disparities between AfAms and NHWs. We propose that the best way to understand these disparities is to move beyond documentation of them to an examination of domains that cause variation in HRQOL among AfAm survivors. This effort, however, should be implemented with a collaboration between academic researchers and community stakeholders.
- Our theoretical model draws heavily on a social-ecological model of health and assumes that the domains of influence include significant stressors linked to racial group membership that result from interpersonal, institutionalized, and structural racism and socioeconomic adversity in the US. We will test this model in a four-wave longitudinal study, recruiting 600 participants from a National Cancer Institute-funded infrastructure grant of 5500 AfAm cancer survivors living in metropolitan Detroit. The study will address the following Specific Aims:
- Aim 1. 1a. To use an academic-community collaboration to create a theoretically and community-grounded model of variability in HRQOL among AfAm cancer survivors. 1b. To evaluate the success of the collaboration with a systematic evaluation of community stakeholders’ perceptions of, and attitudes toward, the collaboration experience.
- Aim 2. To conduct a four-wave longitudinal study of 600 AfAm cancer survivors that empirically tests the relationships proposed in the social-ecological model.
- Aim 3. To collaborate with the community stakeholders in the dissemination of study findings to scientific and lay audiences and to translate study findings and inform future interventions.
Effectiveness and adoption of a Smart home-based social assistive robot for care of individuals with Alzheimer’s Disease
- Funding Agency: National Institutes of Health – National Institute of Aging
- PNWU Researcher: Dr. Heather Fritz, School of Occupational Therapy (sub-awardee)
- Collaborators: Dr. Sajay Arthanat (PI) at University of New Hampshire (prime awardee)
- Award Amount: $2,803,716 for 5 years ($99,149 awarded to PNWU)
- Award #: 1R01AG075892
- Project Summary: Allowing individuals with Alzheimer’s disease (IAD) to age-in-place helps preserve their memories, function, and socio-emotional connections. At the same time, the caregiving burden is high for those supporting IAD to age in place. Relocation to long term care is an option for some IAD, however, the costs associated with assisted living and nursing home care is untenable for many families. Thus, there is a significant need for technological solutions to promote independence, health, and safety of IAD to age-in-place. To address this need, the purpose of this study is to develop a smart home-based social assistive robot (SAR) called Mobile Assistive Robot with Smart Sensing (MARSS) to support IAD to age in place while reducing caregiver burden. Based on a successful pilot test of the original prototype, the study team will pilot test the MARSS in the community (with 8 dyads of IAD and caregivers) and verify its implementation fidelity, robustness as well as behavior change techniques to optimize target engagement of IADs and caregivers. After completing the pilot test of the MARSS in the community, the study team will conduct an 18-month randomized controlled trial to validate the real-world efficacy of MARSS with 60 dyads in two staggered cohorts of IAD and caregivers who will be randomly assign to either the intervention (n=30) or a control group (n=30). The team will gather repeated measures data on the IAD’s functional independence, safety, and physical and cognitive health, and the caregiver’s perceived care burden, autonomy and wellbeing over nine data points, 2 months apart. We will also collect data on the technology’s utilization to understand the influence of the MARSS’s modalities on the intervention outcomes. In addition to much needed empirical evidence on AD-based SARs, the findings will contribute knowledge to create and test advanced yet pragmatic technological solutions to strengthen aging-in-place of IAD.