Postpartum Weight Retention and Cardiometabolic Disparities: The Effects of Contexual, Psychosocial, and Behavioral Factors

项目摘要/摘要 了解生育背景下的体重对于解决 肥胖症在美国人口中的严重流行，特别是在女性和各种 种族/民族群体。这项研究研究将促进我们对可能 解释在产后体重保留和心脏代谢风险方面的种族差异 生孩子的女人。这项研究具有双重目的，即提出方法和评估 通过应用生态瞬时评估(EMA)来评估怀孕、体重和肥胖 实时收集数据，并使用智能手机和其他移动技术 设备作为一种收集数据的手段。我们将同时收集压力、情绪、 通过智能手机实时进行饮食、体育锻炼和定位；以及测量 体重使用蓝牙启用的秤。实时和真实地评估女性 环境通过现有技术可能具有促进健康、实践、 并减轻妇女和提供者的负担。我们也将有能力确定 孕妇和产后数据采集的最佳时间点和频度 人口。 这项研究将是Davis GDM2研究(N=920)的辅助研究(N=350)，这是一个 在不同人群的孕妇中进行的随机对照试验 确定两种妊娠筛查方法对围产儿结局的影响 母亲及其子女的糖尿病和代谢风险概况。我们将跟随女性从 他们怀孕最后三个月至九个月，并定期收集EMA评估；以及联系 GDM2研究的产后1年数据。 研究的目的是：(1)确定PPWR从分娩到1年的种族差异 产后，并确定心理社会、行为和背景/环境因素 造成种族差异；(2)确定心脏代谢谱的种族差异 (血压、低密度脂蛋白/高密度脂蛋白、血红蛋白A1C、胰岛素)产后1年进行心理社会鉴定， 行为和背景/环境因素，这些因素导致了 心脏代谢特征；以及(3)探索潜在的行为和心理社会介质。 环境/环境与PPWR/心脏代谢特征之间的关联。 这项研究旨在支持一项具有长期目标的研究计划，以了解和 在生育方面消除体重和肥胖方面的种族/民族差异。这个 从这项研究中获得的知识将是有效开发多层次的关键 旨在减少妇女肥胖的干预措施、方案和政策。此外， 评估孕期和产后的关键时期有助于了解发育 利用移动技术进行及时干预的新领域。

Project Summary/Abstract Understanding weight in the context of childbearing will be important for addressing the profound obesity epidemic in the US population, particularly among women and various racial/ethnic groups. This research study will advance our understanding of the factors that may explain the racial disparity in postpartum weight retention and cardiometabolic risks among childbearing women. This study has a dual purpose of advancing methods and assessment of pregnancy, weight and obesity by applying ecological momentary assessment (EMA), which is collecting data in real time, and using mobile technology such as smartphones and other devices as a means to collect data. We will simultaneously collect measures of stress, mood, diet, physical activity, and location in real time through smartphones; as well as measures of weight using Bluetooth enabled scales. Assessing women in real time and in their real environment through existing technologies may have the potential to advance health, practice, and reduce the burden on women and providers. We will also have the ability to determine optimal points of time and frequency for data collection among a pregnant and postpartum population. This study will be an ancillary study (N=350) to the Davis GDM2 Study (N=920), which is a randomized controlled trial among a diverse population of pregnant women designed to determine differences in perinatal outcomes for two screening approaches for gestational diabetes and metabolic risk profiles of mothers and their offspring. We will follow women from their last trimester of pregnancy to nine months and collect regular EMA assessments; and link the 1 year postpartum data from the GDM2 Study. The research aims are: (1) Determine the racial disparity in PPWR from delivery through 1 year postpartum and identify the psychosocial, behavioral, and contextual/environmental factors that contribute to the racial disparity; (2) Determine the racial disparity in cardiometabolic profiles (BP, LDL/HDL, hemoglobin A1C, insulin) 1 year after delivery and identify the psychosocial, behavioral, and contextual/environmental factors that contribute to the racial disparity in cardiometabolic profiles; and (3) Explore potential behavioral and psychosocial mediators of the association between context/environment and PPWR/cardiometabolic profiles. This study is intended to support a research program with a long-term goal to understand and eliminate racial/ethnic disparities in weight and obesity in the context of childbearing. The knowledge gained from this study will be critical in effectively developing multilevel interventions, programs and policies aimed at reducing obesity among women. Furthermore, assessing critical periods during pregnancy and postpartum provides insight into developing new areas of just-in-time intervention using mobile technology.