Pathways to LUTS Prevention: A Model for Public Education, Behavioral Skills, and Early Detection

LUTS 预防途径：公共教育、行为技能和早期检测的模型

• 批准号: 9316598
• 负责人: KATHRYN Larsen BURGIO
• 金额: $ 51.38万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9316598
• 关键词: Address; Affect; Age; Aging; Alabama; Attitude; Behavior Therapy; Behavioral; Behavioral Sciences; Biofeedback; Bladder; Bladder Control; Cellular Phone; Clinical; Clinical Trials; Clinical Trials Design; Collaborations; Data; Data Set; Databases; Detection; Development; Discipline of Nursing; Early Diagnosis; Early Intervention; Educational process of instructing; Effectiveness; Epidemiology; Esthesia; Evaluation; Exercise; Factor Analysis; Foundations; Frequencies; Functional disorder; Funding; Future; Geriatrics; Gynecology; Habits; Health; Health behavior; Incidence; Incontinence; Increased frequency of micturition; Individual; Internet; Interstitial Cystitis; Intervention; Intervention Trial; Knowledge; Learning; Literature; Longevity; Longitudinal Studies; Longitudinal cohort study; Misinformation; Modeling; National Health and Nutrition Examination Survey; National Heart, Lung, and Blood Institute; National Institute of Child Health and Human Development; National Institute of Diabetes and Digestive and Kidney Diseases; Nocturia; Nurses; Online Systems; Operative Surgical Procedures; Overactive Bladder; Pathway interactions; Patients; Pelvic Floor Disorders; Pelvic Floor Muscle; Pelvic floor structure; Perioperative; Play; Prevalence; Prevention; Prevention strategy; Prevention trial; Preventive Intervention; Preventive Medicine; Prostatectomy; Provider; Public Health; Radical Prostatectomy; Randomized Controlled Trials; Readiness; Recruitment Activity; Rehabilitation therapy; Research; Research Personnel; Risk; Risk Factors; Role; Self-Administered; Severities; Site; Surveys; Symptoms; Techniques; Testing; Time; Training; United States National Institutes of Health; Universities; Urinary Incontinence; Urology; Veterans; Woman; Women' s Health; Women' s Health Services; Work; base; clinically relevant; diet and exercise; effective therapy; epidemiologic data; epidemiology study; evidence base; interest; lower urinary tract symptoms; men; pelvic organ prolapse; prevent; programs; prospective; public education; public health relevance; randomized trial; research and development; response; screening; skills; telehealth; young woman

 DESCRIPTION (provided by applicant): Lower urinary tract symptoms (LUTS) encompass a wide range of symptoms including urinary incontinence, urinary frequency, urgency, nocturia, bladder pain syndrome, and symptoms of voiding dysfunction. There is an extensive literature describing the many approaches to treatment of LUTS, but much less is known about prevention. Epidemiological studies have identified numerous risk factors for LUTS, but evidence is lacking for the roles of behavioral factors, including how we learn our bladder habits, whether they affect the risk of developing LUTS, and what defines healthy bladder habits. The primary aim of this proposal is to participate as a Clinical Center in the "Prevention of Lower Urinary Tract Symptoms in Women: Bladder Health Clinical Centers" (PLUS) Research Consortium and work with other centers to examine the existing evidence and plan foundational studies for development of future trials of prevention interventions for LUTS. The University of Alabama at Birmingham (UAB) Continence Team is an interdisciplinary group of investigators from behavioral science, geriatrics, preventive medicine, public health, urogynecology, and urology. Our epidemiological work includes identifying risk factors for incident incontinence using the NIA-funded UAB longitudinal Study of Aging, national VA databases, and risk factor analyses of NHANES data. The depth of the UAB team covers all aspects of LUTS clinical trial design and conduct (including NIH multi-site networks), evaluation and treatment of LUTS in women, and a strong track record of recruitment and retention of both patients and control subjects (including being a Vanguard Center for the NHLBI Women's Health Initiative). The second aim is to address known gaps in current epidemiological knowledge, through a prospective longitudinal cohort study to assess a range of behavioral factors and their effect on the incidence and progression of LUTS. Understanding the roles of bladder health behaviors will support the development of a risk model for identifying individuals and groups at risk for LUTS, as well as inform public education initiatives. The third aim is to conduct foundational studies guided by our conceptual framework to develop three potential pathways to prevention of LUTS: public education initiatives targeted across the lifespan to convey knowledge and dispel myths about healthy bladder habits and LUTS; skill-based interventions for young women and at-risk groups to teach evidence-based behavioral skills and healthy bladder habits; and detection of and self-administered interventions for early LUTS. The plan of studies includes 1) the longitudinal cohort study, which will also provide meaningful content for public education campaigns, 2) a survey of providers to assess feasibility of teaching pelvic floor muscle control and healthy bladder habits to young women at a time of relative readiness - the first gynecology encounter, and 3) developing and pilot testing an internet-based, self-administered behavioral intervention including a smart-phone application as a practical first step in addressing early LUTS. Findings from these studies will lay the foundation for future trials of interventions to prevent LUTS in women across the lifespan.

 描述（由申请人提供）：下尿路症状（LUTS）涵盖多种症状，包括尿失禁、尿频、尿急、夜尿、膀胱疼痛综合征和排尿功能障碍症状。有大量文献描述了 LUTS 的多种治疗方法，但对于预防却知之甚少。流行病学研究已经确定了 LUTS 的许多危险因素，但缺乏行为因素的作用证据，包括我们如何了解我们的膀胱习惯， 它们是否会影响患 LUTS 的风险，以及健康排尿习惯的定义是什么。该提案的主要目的是作为临床中心参与“预防女性下尿路症状：膀胱健康临床中心”(PLUS) 研究联盟，并与其他中心合作检查现有证据并规划基础研究，以开发未来 LUTS 预防干预措施的试验。阿拉巴马大学伯明翰分校 (UAB) 失禁团队是一个由来自行为科学、老年病学、预防医学、公共卫生、泌尿妇科和泌尿科的研究人员组成的跨学科小组。我们的流行病学工作包括利用 NIA 资助的 UAB 老龄化纵向研究、国家 VA 数据库以及 NHANES 数据的风险因素分析来确定意外失禁的风险因素。 UAB 团队的深度涵盖了 LUTS 临床试验设计和实施（包括 NIH 多站点网络）、女性 LUTS 评估和治疗的各个方面，以及招募和保留患者和对照受试者的良好记录（包括成为 NHLBI 妇女健康倡议的先锋中心）。第二个目标是通过前瞻性纵向队列研究来评估一系列行为因素及其对 LUTS 发生和进展的影响，从而弥补当前流行病学知识中的已知差距。了解膀胱健康行为的作用将支持开发一个风险模型，用于识别有 LUTS 风险的个人和群体，并为公共教育活动提供信息。第三个目标是在我们的概念框架的指导下进行基础研究，以开发三种预防 LUTS 的潜在途径：对年轻女性和高危人群进行基于技能的干预，以传授基于证据的行为技能和健康的膀胱习惯；早期 LUTS 的检测和自我管理干预措施。研究计划包括 1) 纵向队列研究，这也将为公共教育活动提供有意义的内容，2) 对提供者进行调查，以评估在相对准备阶段（第一次妇科接触）向年轻女性教授盆底肌肉控制和健康膀胱习惯的可行性，以及 3) 开发和试点测试基于互联网的自我管理行为干预措施，包括智能手机应用程序，作为实际的第一步 解决早期的 LUTS。这些研究的结果将为未来预防女性终生 LUTS 的干预措施试验奠定基础。