Maintenance of Ideal Cardiovascular Health across the Life Course in Women

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DESCRIPTION (provided by applicant): This patient-oriented K23 Career Development Award will provide the candidate with the training and research experience essential to launch an independent research career focused on the early prevention of cardiovascular disease in girls and women. Recent research has identified substantially lower cardiovascular morbidity and mortality in those women able to reach middle age with a constellation of physiologic and behavioral factors known as ideal cardiovascular health. However, little is known about earlier factors that are particularly salient for the maintenance of ideal cardiovascular health into adulthood in general or in women specifically. By using a novel technique of creating sequential risk prediction models in two epidemiologic cohorts with overlapping age ranges, the candidate will quantify the relative importance of cardiovascular health-promoting behavioral, physiologic, and psychological factors during the critical life stages of adolescence and early young adulthood. [The candidate will conduct qualitative studies to identify developmentally appropriate strategies for promotion of behaviors identified in the two cohort studies. The candidate will then be poised to write an R01 application focused on developing and evaluating targeted behavioral interventions for promoting ideal health among adolescent and young adult women from a variety of racial/ethnic backgrounds.] The training plan will support all aspects of the research strategy and uniquely prepare the candidate for an independent research career using longitudinal cohort analyses and qualitative research strategies to inform cutting edge patient-oriented behavioral interventions. The coursework, mentorship team, and research experiences are designed to provide synergistic training in 1) life course and chronic disease epidemiology, 2) statistical methods for studying critical windows in the life course, and 3) [patient-oriented health communications research that informs the design of developmentally appropriate behavioral interventions]. The Harvard School of Public Health, Harvard Graduate School of Education, Harvard Catalyst, and Boston Children's Hospital all offer unparalleled environments in these three areas. The candidate has assembled a mentorship team with expertise in cardiovascular epidemiology, child and adolescent health, longitudinal cohort analysis, focus group methodology, qualitative data analysis, and health communication and health promotion with vulnerable populations. Mentored by this team the candidate will be well-suited to achieve her immediate career goals of furthering her training in patient-oriented research and cardiovascular epidemiology, identifying critical windows in the lives of young women for cardiovascular health maintenance, and translating these findings to cardiovascular health promoting strategies in youth. [Training activities and results will inform submission of R01 proposals to conduct trials of behavioral interventions aimed at the unique needs of adolescent girls and young women and to conduct epidemiologic studies of cardiovascular health promoting factors in early childhood and the peri-natal period.] Ultimately the candidate's goals are to deepen the understanding of factors related to the maintenance of cardiovascular health throughout the life course and to design novel and effective interventions that enhance positive factors and counterbalance negative factors related to cardiovascular disease risk.