Abstract P363: Cardiovascular Health as a Mediator of Psychosocial Influences on CVD
Bibliographic record
Abstract
Background: Negative psychosocial factors, such as high stress and poor social support, are strongly associated with disease outcomes, including CVD. Conceptually, it is plausible that better cardiovascular health (CVH) may blunt the association between psychosocial factors and incident CVD. However, few studies have investigated whether CVH, which includes biological and behavioral factors, is a potential pathway between psychosocial factors and CVD. Objective: To investigate whether the association between CVD and psychosocial factors is fully or partially mediated by CVH. Setting: This study was carried out in a nationally representative sample of Canadian adults aged 20 years and older. Data and Methods: This study is a cross-sectional design using data from the Canadian Community Health Survey (CCHS) 2015-2016 database. The CCHS is a nationwide, nationally representative survey that collects information on the health status, health care utilization and health determinants of the Canadian population. The study outcome was CVD, as measured by the self-reported presence of physician-diagnosed heart disease. The potential mediator was individual CVH, defined using the AHA CVH Index (CVHI) and determined using self-reported responses in CCHS. Psychosocial factors included self-reported responses to questions on life stress, work stress, sleep, social support and alcohol and drug use. A structural equation modeling (SEM) approach was then used to explore the mediational role of CVH in the association of CVD with psychosocial factors. Analyses were conducted in MPlus Version 8 software. Results: The majority of the population were males (51%), aged 40-60 (37%), with tertiary education (64%) and of the White race (79%). Overall, the mean CVH of the population was 4.5. Results suggested that CVH and all psychosocial factors, except for life stress predicted, CVD. Additionally, all psychosocial factors, except for life stress and drug use, predicted CVH. Standardized coefficients demonstrated that, of all psychosocial factors, work stress had the highest impact on both CVH (std coeff -0.22, p<0.001) and CVD (std coeff -0.07, p<0.0001). Further analyses demonstrated that CVHI partially mediated the association between CVD and work stress (std coeff -0.02, p<0.001), sleep (std coeff -0.002, p<0.001), alcohol use (std coeff -0.009, p<0.001) and social support (std coeff -0.001, p=0.003). None of the associations were fully mediated by CVH. Conclusion: Results indicated that the association between psychosocial factors and CVD was partially mediated by CVH. That is, while better CVH weakened the association between psychosocial factors and CVD, the direct association between psychosocial factors and CVD remained. Further analyses should investigate whether accounting for individual characteristics such as age, sex and race may reveal full mediation through CVH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.017 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".