Promoting Heart Healthy Behaviors in Youth.

描述（由申请人提供）：该K23指导的以患者为导向的研究职业发展奖的候选人Tammy布雷迪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。她出色的培训和大量的研究为她职业生涯的下一阶段做好了充分的准备，这将使她成功地从高技能的观察研究员过渡到独立的临床科学家进行临床干预试验。在她的培训早期，布雷迪博士被授予约翰霍普金斯彭博公共卫生学院（JHSPH）临床流行病学健康科学硕士学位。在她的培训和早年的教师，她进行了多项研究，涉及初级数据收集和二级数据分析。除了是几个NIH资助的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，观察性队列研究49名高血压儿童，题为原发性高血压儿童左心室肥厚消退的纵向研究。作为主要研究者，她获得了几个机构的资助，以支持这项研究：马里兰州的国家肾脏基金会，美国肾脏病学会，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，一篇是资深作者，还有三篇原创科学手稿将在未来几个月内提交（两篇是第一作者，一篇是资深作者）。认识到额外培训的价值，以进一步她的研究追求，她从NIH/约翰霍普金斯临床和转化研究所获得资金作为KL 2临床研究学者，这使她能够全职参加研究生培训计划在JHSPH临床研究博士课程。她收到了NEMA研究临床研究奖在她的第一个教学年完成接收综合考试的最高分。自从她最初的K23申请，她已经完成了她的学位所需的所有课程，并定于2014年3月12日捍卫她的论文研究。她发展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。由于已知儿童肥胖流行导致成人存在严重的CV疾病，因此预防儿童肥胖和其他CV风险因素至关重要。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，这是她目前研究提案背后的动机。此外，信息技术，特别是手机在青少年中的广泛使用，为切实有效地向青年提供生活方式干预提供了一个难得的机会。在过去的几个月里， 博士布雷迪在六名血压升高的青少年中进行了一项初步研究。这项由马里兰州国家肾脏基金会资助的研究为她提供了关于她提出的干预措施的丰富的定性和定量数据。因此，她正在与她的导师和项目咨询团队合作，以改善传递给参与者的信息，并利用从这项试点研究中获得的知识加强了她的K23研究战略。因此，本提案的总体目标是：（1）测试 假设在肥胖、高血压前期青少年中，一种技术支持的行为健康生活方式干预在降低肥胖、血压（BP）和左心室质量（LVM）方面比标准治疗更有效;（2）比较干预对（a）血压、生长、肥胖的激素调节剂;（B）脂质风险因素;和（c）同一组儿童的昼夜血压和血压变异性。布雷迪博士将在约翰霍普金斯大学丰富的培训环境中开展这项研究，并得到拉里阿佩尔博士、皮特米勒博士和芭芭拉菲武什博士的合作和支持。她还将与她的项目咨询团队的成功成员密切合作：Felicia Hill-Briggs博士，Ben Caballero和Debbie Young; Jeanne查尔斯顿女士;和Arlene Dalcin女士。这些流行病学、临床试验和行为医学领域的领导者将确保她提出的干预性试验的成功完成。这种指导性培训，沿着持续的教学培训，将使布雷迪博士成长为一名独立的儿科临床科学家，设计和进行临床试验，不仅将塑造为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。

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.