Promoting Heart Healthy Behaviors in Youth.

促进青少年心脏健康的行为。

• 批准号: 8919938
• 负责人: Tammy McLoughlin Brady
• 金额: $ 16.08万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-02 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8919938
• 关键词: Academy; Adolescence; Adolescent; Adoption; Adult; Adverse effects; Age; Aldosterone; Am 80; Ambulatory Blood Pressure Monitoring; American; American Heart Association; Angiotensin II; Arrhythmia; Award; Behavior; Behavior Therapy; Behavioral; Behavioral Medicine; Belief; Blood Pressure; Body Weight decreased; Body mass index; Cardiovascular Diseases; Caring; Categories; Cellular Phone; Cessation of life; Child; Childhood; Cholesterol; Clinic; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Computers; Conduct Clinical Trials; Consumption; DASH diet; Data; Data Analyses; Data Collection; Development; Diabetes Mellitus; Disease; Disease Outcome; Doctor of Philosophy; Dyslipidemias; Early intervention trials; Effectiveness; Enrollment; Ensure; Environment; Epidemic; Epidemiology; Essential Hypertension; Evolution; Faculty; Food Processing; Foundations; Funding; Future; Goals; Growth; Health; Health Sciences; Health behavior change; Heart; Heart Diseases; Heart failure; Hormonal; Hour; Hydrocortisone; Hypertension; Information Technology; Institutes; Instruction; Insulin Resistance; Intervention; Intervention Trial; Kidney; Knowledge; Left Ventricular Hypertrophy; Left Ventricular Mass; Leptin; Lipids; Longitudinal Studies; Low-Density Lipoproteins; Maintenance; Manuscripts; Maryland; Measurable; Measurement; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Motivation; Multicenter Studies; Myocardial Infarction; Nephrology; Nutrition Policy; Obesity; Observational Study; Outcome; Participant; Pediatrics; Peer Review; Phase; Physical activity; Physiologic pulse; Pilot Projects; Plasma; Positioning Attribute; Prevalence; Prevention; Primary Health Care; Principal Investigator; Public Health Schools; Publishing; Randomized Controlled Trials; Renin; Research; Research Personnel; Research Proposals; Risk Factors; Role; Schedule; Science; Scientist; Secure; Serum; Shapes; Societies; Sodium; Somatomedins; Technology; Testing; Thyroid Hormones; Time; Training; Training Programs; Translational Research; United States National Institutes of Health; Universities; Video Games; Work; Youth; adverse outcome; arm; base; behavior change; cardiovascular risk factor; career; clinical epidemiology; clinical investigation; density; design; diet and exercise; disorder prevention; empowered; healthy lifestyle; heart dimension/size; high risk; hypertension prevention; improved; intervention effect; intimal medial thickening; learned behavior; lifestyle intervention; lipoprotein cholesterol; medical schools; member; new technology; novel; obesity in children; obesity prevention; prevent; professor; programs; prospective; sedentary; standard care; standard of care; sugar; sweetened beverage; therapeutic lifestyle change; therapy design

DESCRIPTION (provided by applicant): The candidate for this K23 Mentored Patient-Oriented Research Career Development Award, Dr. Tammy Brady, is an Assistant Professor of Pediatrics at the Johns Hopkins University School of Medicine in the Division of Pediatric Nephrology. Her exceptional training and considerable research have prepared her well for this next phase in her career, which will result in her successful transition from highly skilled observational researcher to independent clinician scientist conducting clinical intervention trials Early in her training, Dr. Brady was awarded a Masters in Health Science in Clinical Epidemiology at the Johns Hopkins Bloomberg School of Public Health (JHSPH). During her training and early years on faculty she conducted multiple studies involving primary data collection and secondary data analysis. In addition to being co-investigator on several NIH funded multicenter studies, she has recently completed a year-long prospective, observational cohort study of 49 hypertensive children, entitled Longitudinal Study of Left Ventricular Hypertrophy Regression in Children with Primary Hypertension. As Principal Investigator, she obtained funding from several agencies to support this study: the National Kidney Foundation of Maryland, the American Society of Nephrology, the American Heart Association, and the National Institutes of Health/ Johns Hopkins Institute for Clinical and Translational Research. To date she has published 10 peer-reviewed original science articles, 4 as first author and one as senior author, and has three additional original science manuscripts to be submitted in the coming months (two as first author and one as senior author). Recognizing the value in additional training to further her research pursuits, she secured funding from the NIH/Johns Hopkins Institute for Clinical and Translational Research as a KL2 Clinical Research Scholar which allowed her to enroll full time in the Graduate Training Program for Clinical Investigation PhD program at the JHSPH. She received the NEMA Research Clinical Research Award at the completion of her first didactic year for receiving the highest score on the Comprehensive Examination. Since her initial K23 application, she has completed all of the required coursework for her degree and is scheduled to defend her thesis research on March 12, 2014. An essential component of her evolution into an independent researcher is hands-on mentored training in the development and implementation of a behavioral intervention and the design and conduct of a clinical trial. The research she proposes will accomplish these goals. With the known obesity epidemic in children contributing to the significant CV disease present in adults, prevention of obesity and other CV risk factors in childhood is of the upmost importance. The paucity of available strategies to enhance adolescent engagement in therapeutic lifestyle change, essential to correct the suboptimal learned behaviors contributing to this epidemic, is the motivation behind her current research proposal. Further, the widespread use of information technology, particularly cell phones among adolescents, presents an incredible opportunity to effectively and efficiently deliver lifestyle interventions to youth. Over the last several months, Dr. Brady conducted a pilot study of her proposed intervention among six adolescents with elevated blood pressure. This study, funded by the National Kidney Foundation of Maryland, provided her with rich qualitative and quantitative data regarding her proposed intervention. As a result, she is working with her mentors and Project Advisory Team to improve the messages delivered to participants and has enhanced her K23 research strategy using the knowledge gained from this pilot study. The overall objectives of this proposal are therefore to (1) test the hypothesis that a technology supported behavioral Healthy Lifestyle intervention is more effective than the standard of care on reducing adiposity, blood pressure (BP) and left ventricular mass (LVM) among obese, pre-hypertensive adolescents; and (2) compare the effects of the intervention on (a) hormonal regulators of blood pressure, growth, adiposity; (b) lipid risk factors; and (c) diurnal BP and BP variability among the same group of children. Dr. Brady will carry out this research in the rich training environment of Johns Hopkins University under the collaborative and supportive mentorship of Dr. Larry Appel, Dr. Pete Miller and Dr. Barbara Fivush. She will also work closely with the accomplished members of her Project Advisory team: Drs. Felicia Hill-Briggs, Ben Caballero, and Debbie Young; Ms, Jeanne Charleston; and Ms. Arlene Dalcin. These leaders in the field of epidemiology, clinical trials and behavioral medicine will ensure the successful completion of her proposed interventional trial. This mentored training, along with continued didactic training, will enable Dr. Brady to grow into an independent pediatric clinician scientist, designing and conducting clinical trials that will no only shape the care provided to children at increased CV risk but will also contribute to the expanding knowledge regarding the origins of disease.

描述（由申请人提供）：这位K23指导的以患者为导向的研究职业发展奖的候选人Tammy Brady博士是约翰·霍普金斯大学儿科肾病学系的约翰·霍普金斯大学医学院儿科助理教授。她的出色培训和大量的研究为她的职业生涯的下一阶段做好了很好的准备，这将导致她从高科技的观察研究员到独立临床科学家的成功过渡，在培训的早期进行临床干预试验，Brady博士被授予约翰·霍普金斯·彭博公共健康的临床流行病学临床科学硕士学位。在培训和对教师的早期期间，她进行了多项研究，涉及主要数据收集和次要数据分析。除了对几项NIH资助的多中心研究进行共同投资者外，她最近还完成了一项为期一年的前瞻性，观察性的队列研究，对49名高血压儿童进行了一项，标题为原发性高血压儿童的左心室肥大回归的纵向研究。作为首席研究员，她从多家机构获得了资金来支持这项研究：马里兰州国家肾脏基金会，美国肾脏病学会，美国心脏协会和国立卫生研究院/约翰·霍普金斯临床和转化研究所。迄今为止，她已经发表了10篇由同行评审的原始科学文章，其中4篇作为第一作者，另一位作为高级作家，并在未来几个月内提交了另外三本原始科学手稿（两名作为第一作者，另一位为高级作者）。她认识到额外培训的价值以进一步的研究追求，她从NIH/约翰·霍普金斯临床和转化研究研究所获得了KL2临床研究学者的资金，使她能够全职参加JHSPH的临床研究研究生培训计划。她在第一个教学年份完成时获得了NEMA研究临床研究奖，因为她在全面考试中获得了最高分。自从她最初的K23申请以来，她已经完成了学位的所有必需课程，并计划在2014年3月12日捍卫自己的论文研究。她演变为独立研究人员的重要组成部分是在行为干预以及临床试验的设计和设计方面进行了实践指导的培训。她提出的研究将实现这些目标。随着儿童已知的肥胖症流行，导致成人存在的重要CV疾病，预防肥胖症和其他CV危险因素在儿童时期至关重要。她目前的研究建议背后的动机是对纠正次优的学习行为的可用策略，以增强青少年的治疗生活方式改变，这对于纠正次优的学习行为至关重要。此外，信息技术的广泛使用，尤其是青少年中的手机，为有效，有效地为青年提供了生活方式干预措施提供了一个令人难以置信的机会。在过去的几个月中， 布雷迪博士对六名血压升高的青少年提出的干预进行了试点研究。这项由马里兰州国家肾脏基金会资助的研究为她提供了有关她提出的干预措施的丰富定性和定量数据。结果，她正在与导师和项目咨询团队合作，以改善传递给参与者的信息，并使用此试点研究获得的知识增强了她的K23研究策略。因此，该提案的总体目标是（1）测试 在肥胖，高型前青少年中，技术支持行为健康生活方式干预的技术比降低肥胖，血压（BP）和左心室肿块（LVM）的护理标准更有效。 （2）比较干预对（a）血压，生长，肥胖的荷尔蒙调节剂的影响； （b）脂质危险因素； （c）同一组儿童的昼夜BP和BP变异性。布雷迪博士将在约翰·霍普金斯大学的丰富培训环境中进行这项研究，并在拉里·阿佩尔（Larry Appel），皮特·米勒（Pete Miller）博士和芭芭拉·菲维什（Barbara Fivush）博士的合作和支持性指导下进行。她还将与她的项目咨询团队的成熟成员紧密合作：Drs。 Felicia Hill-Briggs，Ben Caballero和Debbie Young；珍妮·查尔斯顿（Jeanne Charleston）女士；和Arlene Dalcin女士。这些领导者在流行病学，临床试验和行为医学领域，将确保成功完成其拟议的介入试验。这项受过指导的培训以及继续进行的教学培训将使布雷迪博士能够成长为独立的儿科临床医生，设计和进行临床试验，这不仅会塑造给CV风险增加的儿童提供的护理，而且还将有助于扩大有关疾病起源的知识。