Developing an Intervention to Prevent Visceral Fat in Premenopausal Women: (CBID)

制定预防绝经前妇女内脏脂肪的干预措施：(CBID)

• 批准号: 7938930
• 负责人: LYNDA H POWELL
• 金额: $ 140.66万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938930
• 关键词: Aging; Attention; Back; Behavioral; Biometry; Body Composition; Body mass index; Boxing; Cardiovascular Diseases; Chicago; Chronic stress; Clinic; Clinical; Clinical Trials; Communication; Communities; Consensus; Data; Development; Diabetes Mellitus; Diffusion of Innovation; Discipline; Dose; Drops; Elements; Endocrinology; Enhancers; Enrollment; Epidemiologic Studies; Epidemiology; Fatty acid glycerol esters; Female; Friends; Future; Health; Height; Hormonal; Incentives; Individual; Intervention; Length; Life Style; Link; Longitudinal Studies; Maintenance; Manuals; Menopause; Mental Depression; Methods; Motivation; Participant; Patient Self-Report; Phase; Physical Medicine; Physical activity; Pilot Projects; Play; Premenopause; Principal Investigator; Procedures; Protocols documentation; Psychology; Questionnaires; Recording of previous events; Research; Risk; Risk Factors; Role; Screening procedure; Self Determination; Self Efficacy; Social Characteristics; Social Network; Stress; Testing; Testosterone; Treatment Effectiveness; Utility Theories; Visceral; Weight; Woman; Work; abstracting; arm; base; cardiovascular disorder risk; cardiovascular risk factor; clinically significant; communication theory; community based participatory research; design; epidemiologic data; health economics; improved; innovation; interest; intervention effect; phase change; post intervention; prevent; programs; psychologic; randomized trial; research study; sedentary; sex; social; social cognitive theory; theories; therapy design; therapy development; tool; transmission process; waist circumference

DESCRIPTION (provided by applicant): Risk for cardiovascular disease (CVD) increases in women as they traverse the menopause, independently of aging. In a 15-year longitudinal study of women undergoing the menopause, we have shown that menopause increases in the predominance of testosterone in the hormonal milieu which promotes the development of visceral fat, an important CVD risk factor. Although menopause cannot be modified, we have shown that sedentary lifestyle and chronic stress are also independently associated with high levels of visceral fat. Thus, we hypothesize that an intervention that is successful in producing a sustained increase physical activity and reduction in chronic stress could reduce the menopause-related development of visceral fat and, as such, reduce early cardiovascular risk in women. This proposal aims to develop a multi-level intervention targeting simultaneously the individual, the social network, and the community, for the purpose of producing a sustained increase in physical activity and reduction in chronic stress. The targeted community is the same community from which the epidemiologic data were obtained. Thus providing the opportunity to give back by improving health. The research team features expertise in the disciplines of psychology, epidemiology, physical medicine, biostatistics, endocrinology, communications, and health economics. The community partners include participants in the 15-year epidemiologic study and community- based organizations. Development of the intervention has been informed by theory concerned with sustained change, namely Self-Determination Theory, Social Cognitive Theory, Diffusion of Innovation Theory, Community-Based Participatory Research, Communications Theory, and Utility Theory. It will be developed in 3 phases. The first explore psychological and social characteristics in individuals who have been successful at sustaining physical activity over 9 years, determine the best way to prevent drop-outs in the early phase of change, and exploring qualitatively potential activities that would be included in a treatment tool box. The second is a "proof of concept study" aimed at determining optimum length and the value of community support. The third is a controlled pilot study of the refined intervention which will generate estimates needed for the design of a subsequent clinical trial. RELEVANCE: There is an urgent need to find treatments to reduce risk for CVD in women which is their number one killer. We aim to develop an intervention to reduce early risk for developing visceral fat in pre-menopausal women by producing a sustained increase in physical activity and reduction in chronic stress. The setting is in a community that has partnered with us over the past 15 years to provide the epidemiologic data that form the basis of this work. We aim to give back to this community by partnering to develop a program that could improve their health. (End of Abstract)

描述（由申请人提供）： 随着女性进入更年期，心血管疾病（CVD）的风险增加，与年龄无关。在一项对绝经期妇女的15年纵向研究中，我们发现绝经期增加了激素环境中睾酮的优势，这促进了内脏脂肪的发展，这是一个重要的CVD风险因素。虽然更年期不能改变，但我们已经证明久坐不动的生活方式和慢性压力也与高水平的内脏脂肪独立相关。因此，我们假设，一个干预，是成功地产生持续增加体力活动和减少慢性压力，可以减少更年期相关的发展内脏脂肪，因此，降低早期心血管疾病的风险在妇女。这项建议旨在发展一个同时针对个人、社会网络和社区的多层次干预措施，以持续增加身体活动和减少长期压力。目标社区与获得流行病学数据的社区相同。从而提供了通过改善健康来回馈社会的机会。该研究团队具有心理学，流行病学，物理医学，生物统计学，内分泌学，通信和卫生经济学等学科的专业知识。社区合作伙伴包括15年流行病学研究的参与者和社区组织。干预措施的发展受到了与持续变化有关的理论的影响，即自决理论、社会认知理论、创新扩散理论、基于社区的前瞻性研究、传播理论和效用理论。它将分三个阶段开发。第一个探索的心理和社会特征的人已经成功地维持身体活动超过9年，确定最好的方法，以防止辍学的早期阶段的变化，并探索定性的潜在活动，将包括在一个治疗工具箱。第二项是“概念验证研究”，旨在确定最佳期限和社区支助的价值。第三个是一个控制的试点研究的精细干预，这将产生估计需要设计一个后续的临床试验。相关性：迫切需要找到治疗方法来降低女性心血管疾病的风险，这是她们的头号杀手。我们的目标是开发一种干预措施，通过持续增加体力活动和减少慢性压力来降低绝经前妇女发展内脏脂肪的早期风险。背景是在一个社区，在过去的15年里与我们合作，提供流行病学数据，形成这项工作的基础。我们的目标是通过合作开发一个可以改善他们健康的计划来回馈这个社区。(End摘要）