Identifying and Targeting Unique Physical Activity Determinants for Midlife Women

心血管风险和死亡率在中年女性中特别高，这是由于以下因素， 更年期和性别差异在心血管事件症状表现。体力活动（PA） 这对减少中年妇女的风险至关重要;然而，这一群体面临着独特的心理障碍， 巴勒斯坦权力机构很少通过现有干预措施加以解决。现有证据和候选人的试点数据 表明这些障碍是消极情绪，身体满意度和社会比较（即，评价 一个人的PA相对于同龄人的PA）。智能手机应用程序等移动的健康工具能够 在真实的时间干预这些障碍，但开发有效的工具需要一个复杂的 理解（1）PA何时发生，以及PA在特定个体中的决定因素。 环境，以及（2）优化该信息以用于移动的递送的能力。K23培训 该计划将通过以下培训目标来满足这些需求：PA的动态评估 及其心理社会决定因素，先进的统计方法，个人定制的PA计划（与 强调移动的干预发展）、妇女健康和心血管生理学。培训 将包括学徒和教程与专家在每个这些主题，以及课程， 强化门诊评估、移动的应用程序设计和生理学。为了支持这一计划， 拟议的研究将调查中年女性初级保健患者的PA及其决定因素， 心血管风险标志物。本研究的目的1是检验实时心理社会之间的关系， 经验（即，情绪，身体满意度，社会比较）和PA在处于危险中的中年妇女（n=100， 年龄40-60; 27>BMI<50，具有一个额外的心血管风险标志物）。这将允许进一步 优化为中年妇女量身定制的移动的健康工具。本研究的目标2是完善和试点 测试一种为中年高危女性量身定制的新型移动的PA应用程序（n=30，年龄40-60; 27>BMI<50， 其他CVD风险标志物）。实现这些项目目标将产生多个同行评审的手稿 以及一项强有力的R 01提案，该提案侧重于测试一种针对中年妇女的知情、量身定制的移动的干预措施 有患CVD的风险。这项研究建立在候选人的培训日期，并介绍了一个 以创新的方式了解和促进中年妇女的PA。K23计划的目标是 响应NHLBI的战略计划，因为它们将通过增加 了解疾病风险的决定因素，拟议的计划将有助于改善 针对患者需求和障碍的干预措施。优秀的培训，受保护的时间和项目 拟议的K23计划的资源将准备候选人成为一个领先的以病人为导向的 在中年女性中推广PA以降低心血管风险方面具有专业知识的研究员。

Cardiovascular risk and mortality is uniquely elevated among midlife women due to factors such as menopause and gender differences in cardiovascular event symptom presentation. Physical activity (PA) is critical to reducing risk in midlife women; however, this group confronts distinctive psychosocial barriers to PA that rarely are addressed by existing interventions. Current evidence and the candidate’s pilot data indicate that these barriers are negative mood, body satisfaction, and social comparison (i.e., evaluating one’s PA relative to that of peers). Mobile health tools such as smartphone applications have the ability to intervene on these barriers in real time, but developing effective tools requires a sophisticated understanding of (1) when PA occurs and determinants of PA for particular individuals in their natural environments, and (2) the ability to optimize this information for mobile delivery. The proposed K23 training program will address these needs by focusing on the following training goals: ambulatory assessment of PA and its psychosocial determinants, advanced statistical methods, individual tailoring of PA programs (with an emphasis on mobile intervention development), women’s health, and cardiovascular physiology. Training will include apprenticeships and tutorials with experts in each of these topics, as well as coursework in intensive ambulatory assessment, mobile application design, and physiology. To support this plan, the proposed research will investigate PA and its determinants among midlife female primary care patients with cardiovascular risk markers. Aim 1 of this research is to examine relations between real-time psychosocial experiences (i.e., mood, body satisfaction, social comparison) and PA among at-risk midlife women (n=100, age 40-60; 27>BMI<50 with one additional cardiovascular risk marker). This will allow for further optimization of a mobile health tool tailored for midlife women. Aim 2 of this research is to refine and pilot test a novel mobile PA application tailored for at-risk midlife women (n=30, age 40-60; 27>BMI<50 with one additional CVD risk marker). Achieving these project aims will produce multiple peer-reviewed manuscripts and a strong R01 proposal focused on testing a well-informed, tailored mobile intervention for midlife women at risk for developing CVD. This research builds on the candidate’s training to date and introduces an innovative way to understand and promote PA in midlife women. The goals of this K23 program are directly responsive to NHLBI’s strategic plan, as they will allow for improved primary prevention through increased understanding of determinants of disease risk, and the proposed program will contribute to improving interventions tailored to patient needs and barriers. The excellent training, protected time, and project resources of the proposed K23 program will prepare the candidate to become a leading patient-oriented researcher with expertise in PA promotion for cardiovascular risk reduction among midlife women.