1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
My outcome of interest is blood pressure control in kidney transplant patients and its impact on kidney disease progression and cardiovascular outcomes in this population. Adherence to anti-hypertensive medications and regular exercise are two important behavioral factors that play a major role in blood pressure control in kidney transplant patients. Adherence to anti-hypertensive medications including calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers improves blood pressure control in this population which in turn slows kidney disease progression and improves cardiovascular outcomes in kidney transplant population. Similarly, regular exercise can improve blood pressure control in hypertensive kidney transplant patients by helping them maintaining their weight under control and therefore, can improve kidney and cardiovascular outcomes.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
I’m planning to do a study comparing the level of adherence to anti-hypertensive medications in kidney transplant patients from different races and will evaluate if possible difference levels of adherence to anti-hypertensive medications is associated with different outcomes in terms of blood pressure control, kidney disease progression and cardiovascular outcomes in these populations.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
Although key health behaviors like smoking, exercise and diet are strongly influenced by neighborhood, education and income, they remain important factors in influencing health outcomes. These behaviors can be studied as mediators for socioeconomic factors such as neighborhood, income, and/or education and it’s usually easier to target these behavioral factors to improve health outcomes as compared with the socioeconomic factors.