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

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 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.