Promoting Heart Healthy Behaviors in Youth.

描述（由申请人提供）：本次K23指导患者导向研究职业发展奖的候选人Tammy Brady博士是约翰霍普金斯大学医学院儿科肾病科的儿科助理教授。她的特殊训练和大量的研究为她的职业生涯的下一阶段做好了准备，这将导致她从高技能的观察研究员成功过渡到进行临床干预试验的独立临床医生科学家。在她的培训早期，Brady博士被授予约翰霍普金斯大学彭博公共卫生学院（JHSPH）临床流行病学健康科学硕士学位。在她接受培训和早期的教学期间，她进行了多项研究，包括主要数据收集和次要数据分析。除了作为NIH资助的几项多中心研究的共同研究者，她最近完成了一项为期一年的前瞻性观察队列研究，对49名高血压儿童进行了研究，题为原发性高血压儿童左心室肥厚消退的纵向研究。作为首席研究员，她从几个机构获得了资助来支持这项研究：马里兰州国家肾脏基金会、美国肾病学会、美国心脏协会和美国国立卫生研究院/约翰霍普金斯临床和转化研究所。到目前为止，她已经发表了10篇经过同行评审的原创科学文章，其中4篇是第一作者，1篇是高级作者。在接下来的几个月里，她还将提交另外三篇原创科学论文（两篇是第一作者，一篇是高级作者）。认识到额外培训对进一步研究的价值，她获得了美国国立卫生研究院/约翰霍普金斯临床和转化研究所的资助，成为KL2临床研究学者，这使她能够全日制参加JHSPH临床研究博士课程的研究生培训计划。她在第一学年的综合考试中获得最高分，获得了NEMA研究临床研究奖。自她第一次申请K23以来，她已经完成了学位要求的所有课程，并计划于2014年3月12日进行论文答辩。她成为一名独立研究人员的一个重要组成部分是在行为干预的开发和实施以及临床试验的设计和实施方面的实践指导培训。她提出的研究将实现这些目标。众所周知，儿童肥胖的流行会导致成人心血管疾病的发生，因此预防儿童肥胖和其他心血管危险因素至关重要。缺乏可用的策略来提高青少年参与治疗性生活方式的改变，这对于纠正导致这种流行病的次优学习行为至关重要，这是她目前研究计划背后的动机。此外，信息技术的广泛使用，特别是手机在青少年中的广泛使用，为有效和高效地向青少年提供生活方式干预提供了难得的机会。在过去的几个月里

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.