{"doi":"10.1093/aje/kwad159","title":"Examining the Relationship Between Multilevel Resilience Resources and Cardiovascular Disease Incidence, Overall and by Psychosocial Risks, Among Participants in the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study","abstract":"We examined relationships between resilience resources (optimism, social support, and neighborhood social cohesion) and cardiovascular disease (CVD) incidence and assessed potential effect-measure modification by psychosocial risk factors (e.g., stress, depression) among adults without CVD in 3 cohort studies (2000-2018): the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. We fitted adjusted Cox models accounting for within-neighborhood clustering while censoring at dropout or non-CVD death. We assessed for effect-measure modification by psychosocial risks. In secondary analyses, we estimated standardized risk ratios using inverse-probability-weighted Aalen-Johansen estimators to account for confounding, dropout, and competing risks (non-CVD deaths) and obtained 95% confidence intervals (CIs) using cluster bootstrapping. For high and medium (versus low) optimism (n = 6,243), adjusted hazard ratios (HRs) for incident CVD were 0.94 (95% CI: 0.78, 1.13) and 0.90 (95% CI: 0.75, 1.07), respectively. Corresponding HRs were 0.88 (95% CI: 0.74, 1.04) and 0.92 (95% CI: 0.79, 1.06) for social support (n = 7,729) and 1.10 (95% CI: 0.94, 1.29) and 0.99 (95% CI: 0.85, 1.16) for social cohesion (n = 7,557), respectively. Some psychosocial risks modified CVD HRs. Secondary analyses yielded similar findings. For optimism and social support, an inverse relationship was frequently most compatible with the data, but a positive relationship was also compatible. For neighborhood social cohesion, positive and null relationships were most compatible. Thus, specific resilience resources may be potential intervention targets, especially among certain subgroups.","journal":"American Journal of Epidemiology","year":2023,"id":386473,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9428,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":494488,"name":"Akilah Dulin","orcid":"0000-0002-0769-1014","position":1,"is_corresponding":false},{"id":528992,"name":"Matthew M. Scarpaci","orcid":"0000-0003-2173-3791","position":2,"is_corresponding":false},{"id":731433,"name":"Laura Dionne","orcid":"0000-0003-4828-7314","position":3,"is_corresponding":false},{"id":430018,"name":"Belinda L. Needham","orcid":"0000-0001-5939-2027","position":4,"is_corresponding":false},{"id":251225,"name":"Mario Sims","orcid":"0000-0002-2554-8932","position":5,"is_corresponding":false},{"id":245135,"name":"Alka M. Kanaya","orcid":"0000-0002-8903-1457","position":6,"is_corresponding":false},{"id":339101,"name":"Namratha R. Kandula","orcid":"0000-0003-2570-3426","position":7,"is_corresponding":false},{"id":461952,"name":"Eric B. Loucks","orcid":"0000-0002-9962-0386","position":8,"is_corresponding":false},{"id":420142,"name":"Joseph L. Fava","orcid":"0000-0001-7129-7903","position":9,"is_corresponding":false},{"id":400203,"name":"Charles B. Eaton","orcid":"0000-0002-7723-9461","position":10,"is_corresponding":false},{"id":377144,"name":"Chanelle J. Howe","orcid":"0000-0001-5379-472X","position":11,"is_corresponding":false},{"id":684507,"name":"Jee Won Park","orcid":"0000-0002-8195-6359","position":0,"is_corresponding":true}],"reference_count":78,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:18:00.717763Z","pmid":"37442807","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}