Abstract Cardiovascular-related morbidity and mortality among young adults are rising, and disparities are stark among young Black women compared to White women. Psychosocial factors, such as racism, perceived stress, and lack of social support, contribute to racial inequities in cardiovascular disease. Psychosocial factors also negatively influence physical activity and other behaviors essential for optimal cardiovascular health (CVH), but few interventions focus on these critical factors. Most recently, the social upheaval during the COVID-19 pandemic, as well as a surge in events placing a spotlight on racism in America, amplified the psychosocial stress experienced by many Black women. At the same time, social distancing required by the pandemic may have frayed social networks, disrupting support systems and typical coping strategies. There is a pressing need for culturally tailored, biobehavioral interventions to mitigate what research suggests will be an uptick in cardiovascular disease related to the COVID-19 pandemic, but first, an assessment of the impacts of the pandemic and racial stressors on CVH behaviors is needed, and rigorous data on the social networks. The proposed study builds on an existing randomized dyadic intervention for Black adults hospitalized with a COVID-19 infection (R01NR020127). By focusing on young Black women (ages 18 – 39) with hypertension or other cardiovascular disease risk factors who are COVID-19 survivors but were not hospitalized, we will provide comparison data from a non-hospitalized cohort. We will use a concurrent triangulation mixed methods design to assess the influence of structural and social determinants of health and the COVID-19 pandemic on quality of life and CVH behaviors (e.g., physical activity, diet, and sleep) (aim 1). In addition, we will characterize the social networks of young Black women, including the processing of stressful experiences, sources of strain, and perceived opportunities for future network/dyadic interventions (aim 2). The proposed research will contribute to the parent study by analyzing variables already being collected (e.g., social support) and proposing new data collection on social networks, including dyadic relationships. This study is novel in its focus on CVD prevention in young adulthood and rigorous assessment of stress coping, including racism, within social networks using quantitative methods to inform future tailored, biobehavioral interventions.

Project Narrative Deaths from heart disease are on the rise for young women, and Black women are disproportionately affected. The proposed research assesses the influence of structural and social determinants of health and COVID-19-related factors on young Black women's quality of life and cardiovascular health behaviors. Also, we will characterize the social networks with a focus on how stress is processed with network members, strain and support within the network, and opportunities for future biobehavioral interventions tailored to the needs of this population.