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 research is focused on increasing the number of observations of cognitive function, mood, daily activities, exercise, and sleep amongst people with dementia. These measurements are typically measured once per year during a clinical visit, and little is known about how these measurements change for patients on shorter timescales (months or weeks). The health outcome of interest is a measurable change in cognitive function over one year, and we will look for correlations to other collected measurements. Evidence in the literature suggests that health behaviors such as exercise and smoking are both causally related to dementia. Moderate to vigorous exercise decreases the development and progress of dementia, while smoking tobacco can cause vascular damage and increase the risk of dementia.
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.
My research aims to study the role of exercising in the development and progression of frontotemporal dementia. To collect activity data, we are equipping participants with a Fitbit device that measures steps and heartrate. This will allow us to observe bouts of exercise in addition to baseline step counts. This data is limited even amongst the general public, but it is well worth collecting, as many public health recommendations include relatively vague statements like “30 – 60 minutes of moderate exercise per day.” This type of exercise data has rarely if ever been collected amongst individuals with dementia even though evidence has suggested for years that exercise is an important therapeutic and preventive behavior. We will also measure this data alongside a proxy for social sphere/social exclusion. Our study participants will download a mobile application (used for collecting remote, non-clinical measurements of cognitive function, etc.) that will collect location of the participant. Using a maximum radius of travel analysis, we will be able to determine whether a participant is leaving the house or going places in their community. We will be able to track the development of cognitive issues or not alongside the maximum radius of travel.
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?
We certainly do not know everything there is to know about key health behaviors or socioeconomic factors that influence the behaviors. Pampel et al. described how socioeconomic factors comprising one’s SES not only influence which health behaviors an individual will have, but also the effect that those behaviors will have. For example, some people with a lower SES may exercise to the extent that they walk most places due to lack of travel options. This is often occurring alongside feelings of stress, which is distinct from leisurely walking by someone with a higher SES. Scenarios such as this provide evidence that measuring and studying only socioeconomic factors or health behaviors alone will fall short of the larger story, and the true connections between SES, health behaviors, and health will not be fully understood.