University of Pennsylvania+ PLUS Clinical Center (PENN+PLUS CC)

 描述(由申请者提供)：下尿路症状是女性一生中普遍存在的，令人痛苦和昂贵的症状。它们的特征是储尿、排尿和排尿后症状，并与尿路感染、膀胱过度活动和膀胱疼痛综合征有关。下尿路症状的出现意味着“异常”或不健康的膀胱。通过治疗可改变的危险因素和改善膀胱习惯来促进膀胱健康，可能会在女性一生中减少这些症状的发生率。我们的长期目标是制定有效的干预措施，以减少以下四个生命阶段的妇女的终生下尿路症状和尿路感染的风险：青春期女孩(生殖前年份)、青壮年(生殖年份)、中年(生殖后年份)和老年妇女(65岁及以上)。我们计划：1)研究症状管理模型的适应性，以确定预测四个生命阶段膀胱健康的风险和保护因素；2)研究风险和保护因素对四个年龄段女性下尿路症状和尿路感染的共同而独特的影响；以及3)与PLUS研究联盟成员合作，设计和实施定性和队列研究以及临床试验，重点关注确定和减少与女性膀胱健康相关的风险因素。具体地说，我们将就下尿路症状的风险、保护因素和预防干预措施进行证据综合；使用定性方法描述青春期女孩和妇女的膀胱健康经历及其症状管理策略；根据我们的定性研究结果开发工具用于联合站点的纵向研究；并使用流行病学和电子健康记录数据库(包括临床数据和索赔数据)来确定女性尿路感染的危险因素。此外，我们将与PLUS研究联盟合作，设计和进行多点观察性研究和随机对照试验，以确定和减少选定女性人群中与膀胱健康相关的风险因素。

 DESCRIPTION (provided by applicant): Lower urinary tract symptoms are prevalent, distressing, and costly for women across the life span. They are characterized by storage, voiding, and postmicturition symptoms, and associated with urinary tract infections, overactive bladder, and bladder pain syndrome. The occurrence of lower urinary tract symptoms implies an "abnormal" or unhealthy bladder. Promotion of bladder health through treatment of modifiable risk factors and improving bladder habits may decrease the incidence of these symptoms over a woman's lifetime. Our long-term goal is to develop effective interventions to reduce the lifetime risk of lower urinary tract symptoms and urinary tract infections in women across four life-stage groups: adolescent girls (pre-reproductive years); young adult (reproductive years), midlife (post- reproductive years) and older women (65 years and older). We plan to: 1) examine the utility of an adaption of the Symptom Management Model to identify risk and protective factors that predict bladder health in the four life-stages; 2) examine the shared and unique impact of risk and protective factors on lower urinary tract symptoms and urinary tract infection in women in each of the four age groups; and 3) design and conduct qualitative and cohort studies and clinical trials in collaboration with PLUS Research Consortium members that are focused on identifying and reducing risk factors related to bladder health in women. Specifically, we will conduct an evidence synthesis on the risk and protective factors and preventive interventions for lower urinary tract symptoms; use qualitative methodology to describe adolescent girls and women's bladder health experiences and their symptom management strategies; develop an instrument to be used in longitudinal studies in consortium sites based on our qualitative research results; and use epidemiological and electronic health record databases (including clinical data and claims data) to determine risk factors for urinary tract infections in women. In addition, we will design and conduct multisite observational studies and randomized controlled trials in collaboration with PLUS Research Consortium to identify and reduce risk factors associated with bladder health in selected female populations.