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，原因包括 更年期和性别差异在心血管事件症状表现中的作用。体力活动(PA)是 对降低中年女性的风险至关重要；然而，这一群体面临着独特的心理社会障碍 PA现有的干预措施很少能解决这一问题。目前的证据和候选人的飞行员数据 指出这些障碍是负面情绪、身体满意度和社会比较(即评价 相对于同龄人的PA)。智能手机应用程序等移动健康工具能够 实时干预这些障碍，但开发有效的工具需要复杂的 了解(1)PA何时发生以及特定个体在其自然状态下PA的决定因素 环境，以及(2)针对移动交付优化此信息的能力。拟议的K23培训 该计划将通过侧重于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 强调移动干预发展)、妇女健康和心血管生理学。培训 将包括这些主题中每一个主题的专家的学徒培训和教程，以及 密集的非卧床评估、移动应用程序设计和生理。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。这项研究的目标1是检查实时心理社会之间的关系 高危中年妇女(n=100)的经历(即情绪、身体满意度、社交比较)和PA 年龄40-60岁；27；BMI&lt；50岁，另有一个心血管风险标记物)。这将允许进一步 优化为中年妇女量身定做的移动保健工具。这项研究的目标2是提炼和试点 测试为高危中年女性量身定做的新型移动PA应用程序(n=30，40-60岁；27；BMI&lt；50；其中一款 其他心血管疾病风险标记物)。实现这些项目目标将产生多个同行评审的手稿 一份强有力的R01提案侧重于测试针对中年女性的消息灵通、量身定做的移动干预 有患心血管疾病的风险。这项研究建立在候选人迄今的培训基础上，并介绍了一种 以创新的方式在中年女性中了解和推广PA。这个K23计划的目标是直接 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，以及拟议的计划将有助于改进 针对患者需求和障碍量身定做的干预措施。优秀的培训、受保护的时间和项目 拟议的K23计划的资源将为候选人成为领先的以患者为导向的人做好准备 在PA促进中年女性降低心血管风险方面具有专业知识的研究人员。

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.