Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium Yale Clinical Research Center

1下尿路症状（LUTS）在美国（US）的女性中非常普遍， 2深刻的健康，社会和经济影响。然而，许多女性并不了解这些健康 3后果，甚至有症状的妇女往往不寻求治疗。大多数的LUTS研究和 4临床实践的重点是治疗受影响最严重的女性子集;因此， 五是预防为主。提高对LUTS发展的风险和保护因素的认识， 6.妇女在整个生命过程中的情况对制定和评价预防干预措施至关重要。 7预防下尿路症状（PLUS）联盟的目标是进行合作， 8项跨学科研究，为未来的干预研究建立证据基础， 9健康和预防青少年和成年妇女的LUTS。耶鲁大学临床研究中心 在过去的4年里，10人通过参与和领导PLUS基础工作为这一努力做出了贡献，包括 11.制定概念框架，进行定性和定量研究，制定战略规划， 12措施和方案的制定，以及科学家，临床医生和 13.通过出版物、会议介绍和社区外展工作向普通公众宣传。我们是理想 14个定位为在下一个周期继续对PLUS研究计划做出有影响力的贡献， 15在行为科学方面的经验和专业知识，概念化和设计大型队列研究，以及 16.让不同的社区参与者为预防研究提供信息。 17利用生态系统理论和PLUS Consortium概念框架，我们将进行 18项跨学科预防研究，调查对个人膀胱的多层次影响- 19相关行为和膀胱健康在整个生命过程中。我们的目标是：（1）积极促进 20一个纵向的国家、基于人口的观察队列的概念化、设计和实施 21项研究检查了女性一生中的膀胱健康;（2）分析国家队列研究的数据 22以识别与社交行为相关的个人、社会和环境因素（例如，频率， 23位置，回避），适应行为的开始和使用（例如，修改活动和流体，使用 24吸收产品、骨盆底肌肉训练、保健或信息寻求），以及随后的膀胱 25健康状况随着时间的推移;和（3）进行混合方法试点研究，以确定如何家庭和学校 26种环境影响青少年女性的生育信念，行为和膀胱健康状况，并确定 27个行为和环境变化的机会，可以帮助计划未来的干预研究。这 28创新方法将评估促进膀胱健康和促进LUTS的社会生态因素 第29章开始和发展调查结果将用于告知预防策略，最终有助于减少 30 LUTS的负担，促进青少年和成年女性的膀胱健康。

1 Lower urinary tract symptoms (LUTS) are highly prevalent among women in the United States (US) with 2 profound health, social, and economic implications. However many women do not understand these health 3 consequences, and even symptomatic women often do not seek treatment. A majority of LUTS research and 4 clinical practice has focused on treatment of the most affected subset of women; thus the evidence base for 5 prevention is sparse. An improved understanding of risk and protective factors for LUTS development in 6 women across the life course is essential to inform the development and evaluation of prevention interventions. 7 The goal of the Prevention of Lower Urinary Tract Symptoms (PLUS) Consortium is to conduct collaborative, 8 transdisciplinary studies to establish the evidence base for future intervention studies to promote bladder 9 health and prevent LUTS in adolescent and adult women. The Yale Clinical Research Center has substantively 10 contributed to this effort over the last 4 years by engaging in—and leading—PLUS foundational work including 11 the development of a conceptual framework, formative qualitative and quantitative research, strategic planning, 12 measure- and protocol-development, and the active engagement of communities of scientists, clinicians, and 13 the lay public through publications, conference presentations, and community outreach efforts. We are ideally 14 positioned to continue impactful contributions to PLUS research initiatives in the next cycle, bringing deep 15 experience and expertise in behavioral science, conceptualizing and designing large cohort studies, and 16 engaging diverse community participants to inform prevention research. 17 Drawing on ecological systems theory and using the PLUS Consortium conceptual framework, we will conduct 18 transdisciplinary prevention research that investigates multiple levels of influence on individuals’ bladder- 19 related behaviors and bladder health across the life course. Our aims are to: (1) Actively contribute to the 20 conceptualization, design, and implementation of a longitudinal national, population-based observational cohort 21 study examining women’s bladder health across the life course; (2) Analyze data from the national cohort study 22 to identify individual, social, and environmental factors associated with toileting behavior (e.g., frequency, 23 position, avoidance), the onset and use of adaptive behaviors (e.g., modifying activities and fluids, use of 24 absorptive products, pelvic floor muscle training, health care or information seeking), and subsequent bladder 25 health status over time; and (3) Conduct a mixed methods pilot study to determine how home and school 26 environments influence adolescent women’s toileting beliefs, behaviors, and bladder health status and identify 27 opportunities for behavioral and environmental changes that can help plan future intervention studies. This 28 innovative approach will assess social ecological factors that promote bladder health and contribute to LUTS 29 initiation and progression. Findings will be used to inform preventative strategies that will ultimately help reduce 30 the burden of LUTS and promote bladder health in adolescent and adult women.