NORTHWESTERN UNIVERSITY PLUS CLINICAL SITE

项目摘要 下尿路症状(LUT)在女性中很常见，对日常生活活动有负面影响 和生活质量，造成医疗和心理疾病和巨大的经济负担。因为 在LUTS对女性的有害后果中，了解最佳的膀胱健康是至关重要的。vt.给出 女性尿路症状的复杂性和异质性，需要跨学科的研究来 筛选发生膀胱症状的危险因素，促进保护因素的优化 膀胱健康，以及针对预防计划的机制，以扰乱膀胱的因果通路 到目前为止，关于LUTS的文献主要集中在健康的非西班牙裔白人女性 出现症状并已经参与医疗保健系统的保险。因此，现存的 预防和治疗方法不适用于弱势群体，如少数民族和 服务不足的女性。在了解少数族裔和未得到充分服务的人的膀胱健康方面仍然存在重大差距 妇女，在那里存在着严重的健康差距。设计良好的尿毒症纵向队列研究 在不同的样本中，种族/族裔少数群体的代表性很好，严重缺乏症状。 与PLUS研究联盟一致，我们的目标是超越没有症状和 将膀胱健康优化为“与膀胱相关的身体、心理和社会健康的完整状态” 功能。“因此，这个项目的主要目标是评估生物、心理和社会因素的影响 (心理/行为)、人际、制度、环境和社会因素对膀胱健康的影响 在PLUS框架内使用定性和定量方法的不同妇女。混合的- 方法本项目的研究方法包括：具体目标1.开展纵向、观察性研究 在不同的青春期和成年女性队列中，就种族/民族、年龄、收入、 教育、健康素养、保险状况、性取向和就业，具体目标2.确定 影响不同女性膀胱健康的因素和行为，以及具体目标3.创建筛查 膀胱健康的工具，是可靠的，对不同的妇女有效。我们假设社会 健康、隐性偏见和歧视的决定因素将与 随着时间的推移，LUTS患者的膀胱健康和与医疗系统的参与度。我们还假设 我们开发的筛查器将评估所有女性(包括不同人群)的膀胱健康状况 存在差异)，并将以高可靠性、有效性、 准确性、敏感性和特异性，并将受访者的负担降至最低。这次U01的影响将是 在不同的妇女群体中建立一个新的关于风险和保护因素的知识库。

Project Summary Lower urinary tract symptoms (LUTS) are common in women and negatively impact activities of daily living and quality of life, resulting in medical and psychological morbidity and enormous economic burden. Because of the deleterious consequences of LUTS on women, understanding optimal bladder health is essential. Given the complexity and heterogeneity of women with urinary symptoms, transdisciplinary research is needed to screen for risk factors for the development of bladder symptoms, protective factors that facilitate optimized bladder health, and mechanisms to target for prevention programs to disrupt causal pathways to bladder symptoms To date, the literature on LUTS has mostly focused on non-Hispanic White women with health insurance who present with symptoms and are already engaged with the healthcare system. Thus, extant prevention and treatment approaches are not generalizable to vulnerable populations like minority and underserved women. Significant gaps remain in understanding bladder health for minority and underserved women, where significant health disparities exist. Well-designed longitudinal cohort studies of urinary symptoms in diverse samples in which racial/ethnic minorities are well represented are severely lacking. Consistent with the PLUS Research Consortium, our objective is to move beyond the absence of symptoms and optimize bladder health as “a complete state of physical, mental, and social well-being related to bladder function.” Therefore, the primary goal of this project is to assess the influence of biological, psychosocial (mind/behavior), interpersonal, institutional, environmental, and societal factors on bladder health among diverse women using qualitative and quantitative approaches within the PLUS framework. The mixed- methods approach of this project includes: Specific Aim 1. Conduct a longitudinal, observational study of bladder health in a diverse cohort of adolescent and adult women with respect to race/ethnicity, age, income, education, health literacy, insurance status, sexual orientation, and employment, Specific Aim 2. Determine factors and behaviors that influence bladder health in diverse women, and Specific Aim 3. Create a screening tool for bladder health that is reliable and valid across diverse women. We hypothesize that social determinants of health, implicit bias, and discrimination will be significantly related to the trajectory of bladder health and engagement with the healthcare system over time for LUTS. We also hypothesize that the screener we develop will assess bladder health in all women (including diverse populations in which disparities exist) and will identify women at risk for future bladder symptoms with high reliability, validity, accuracy, sensitivity, and specificity and minimal burden to the respondent. The impact of this U01 will be the curation of a novel knowledge base on risk and protective factors in diverse populations of women.