Pathways to Lower Urinary Tract Symptoms Prevention in Adolescent and Adult Women.

项目概要/摘要 下尿路症状（LUTS）包括广泛的症状，包括尿失禁， 尿频、尿急、尿痛、膀胱疼痛、尿路感染和排尿症状。有一个 大量文献描述了许多治疗LUTS的方法，但对预防知之甚少。 预防下尿路症状（PLUS）联盟是一个跨学科的科学网络 成立的目的是扩大研究范围，从治疗LUTS到促进膀胱健康和预防 在青少年和女性的整个生命过程中的LUTS。尽管许多流行病学研究的风险因素 对于LUTS，很少有研究检查促进膀胱健康的因素。一个关键的差距是在理解 什么定义了健康的排尿和排尿行为，以及这些行为如何随着时间的推移影响膀胱健康。 我们的总体假设是，不适应排尿和排尿行为导致膀胱变差 青少年和成年妇女健康。这项建议的主要目的是继续我们的参与 作为PLUS的临床研究中心，与其他中心合作设计和进行纵向研究， 队列研究，为制定未来预防干预措施以促进膀胱健康奠定基础 预防LUTS。位于伯明翰的亚拉巴马大学（UAB）团队是一个跨学科的团队， 在LUTS临床研究，行为医学，老年医学， 青少年医学，预防科学，公共卫生，流行病学，生物统计学，健康差距， 医学社会学我们的团队准备在以下方面提供专业知识：1）纵向研究的设计和实施， 2)LUTS的评估和治疗（包括临床检查和生物标本采集），3）定性 方法，4）招募和保留有/无LUTS的参与者的不同样本，以及5）社区 订婚第二个目标是在纵向队列研究的基础上，研究两个额外的潜在问题。 膀胱健康和LUTS的风险/保护因素是未来干预研究的合理目标。在 除了在国家队列中测试一些其他因素外，我们还建议检查1） 邻里劣势与空洞和拥挤行为有关，使用区域发展指数，以及 2)使用步态速度和生物标志物的功能能力与排尿和排便行为的关联 炎症了解这些因素的作用将有助于发展模型，以确定在- 风险的个人和群体，以及宣传教育举措。第三个目标是发展和进行 与促进健康排尿和排便行为相关的试点基础研究。第一项研究旨在 了解使用移动的应用程序的青少年在不同环境下的排尿和排便行为 地理信息系统地图。第二个目标是开发一个移动的健康自我管理 促进健康膀胱行为的教育计划。这些项目将为 发展未来的干预研究，以促进整个生命过程中的膀胱健康。

PROJECT SUMMARY/ABSTRACT Lower urinary tract symptoms (LUTS) encompass a wide range of symptoms, including urinary incontinence, urinary frequency, urgency, nocturia, bladder pain, urinary tract infections, and voiding symptoms. There is an extensive literature describing the many approaches to treatment of LUTS, but less is known about prevention. The “Prevention of Lower Urinary Tract Symptoms (PLUS) Consortium is a transdisciplinary scientific network established to expand research beyond the treatment of LUTS to promotion of bladder health and prevention of LUTS in adolescents and women across the life course. Despite many epidemiologic studies on risk factors for LUTS, little research has examined factors that promote bladder health. One key gap is in understanding of what defines healthy voiding and toileting behaviors and how these behaviors affect bladder health over time. Our overarching hypothesis is that maladaptive voiding and toileting behaviors contribute to poorer bladder health among adolescent and adult women. The primary aim of this proposal is to continue our participation as a clinical research center in PLUS and collaborate with other centers to design and conduct a longitudinal cohort study that lays the foundation for developing future prevention interventions to promote bladder health and prevent LUTS. The University of Alabama at Birmingham (UAB) team is an interdisciplinary group of investigators with collective expertise in LUTS clinical research, behavioral medicine, geriatric medicine, adolescent medicine, prevention science, public health, epidemiology, biostatistics, health disparities, and medical sociology. Our team is poised to contribute expertise on 1) design and conduct of longitudinal studies, 2) evaluation and treatment of LUTS (including clinical examination and bio-specimen collection), 3) qualitative methods, 4) recruitment and retention of diverse samples of participants with/without LUTS, and 5) community engagement. The second aim is to build on the longitudinal cohort study to examine two additional potential risk/protective factors for bladder health and LUTS that are plausible targets for future intervention studies. In addition to testing a number of other factors in the national cohort, we propose to examine 1) the role of neighborhood disadvantage in relation to voiding and toileting behaviors, using the Area Deprivation Index, and 2) the association of functional ability with voiding and toileting behaviors using gait speed and bio-markers of inflammation. Understanding the role of these factors will support the development of models for identifying at- risk individuals and groups, as well as inform education initiatives. The third aim is to develop and conduct pilot foundational studies related to promoting healthy voiding and toileting behaviors. The first study aims to understand voiding and toileting behaviors across environments among adolescents using a mobile application with geographic information system mapping. The second aims to develop a mobile health self-management educational program for promoting healthy bladder behaviors. These projects will lay the foundation for the development of future research on interventions to promote bladder health across the life course.