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

1下尿路症状(LUT)在美国女性中非常普遍， 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。大部分LUTS研究和 4临床实践的重点是对受影响最严重的妇女亚群的治疗；因此， 5预防是稀疏的。提高对LUTS发生的风险和保护因素的认识 6整个生命过程中的妇女对制定和评估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，为未来促进膀胱的干预研究奠定证据基础 9青春期和成年妇女的健康和预防LUTS。耶鲁大学临床研究中心有实质性的 在过去的4年里，10人通过参与和领导基础工作为这一努力做出了贡献，包括 11发展概念框架、形成性定性和定量研究、战略规划、 12测量和方案的开发，以及科学家、临床医生和 13通过出版物、会议报告和社区外展努力向公众宣传。我们是最理想的 14准备在下一个周期继续对PLUS研究计划做出有影响力的贡献，带来深刻的 15在行为科学、概念化和设计大型队列研究方面的经验和专业知识，以及 16邀请不同的社区参与者为预防研究提供信息。 17借鉴生态系统理论，利用PLUS联合体概念框架，我们将进行 18项跨学科的预防研究，调查了对个人膀胱的多个层面的影响 19个相关行为和整个生命过程中的膀胱健康。我们的目标是：(1)积极为 20国家纵向人口观测队列的概念化、设计和实施 21项研究检查女性整个生命过程中的膀胱健康；(2)分析来自国家队列研究的数据 22以识别与如厕行为相关联的个人、社会和环境因素(例如，频率， 23姿势、回避)、适应行为的开始和使用(例如，修改活动和液体、使用 24吸收产品、盆底肌肉训练、保健或寻求信息)，以及随后的膀胱 25随时间推移的健康状况；以及(3)进行一项混合方法试点研究，以确定家庭和学校 26环境影响青春期女性的如厕信念、行为和膀胱健康状况，并确定 27个可以帮助计划未来干预研究的行为和环境变化的机会。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 29.启动和进展。研究结果将被用来为预防策略提供信息，这些策略最终将有助于减少 30减少LUTS的负担，促进青春期和成年妇女的膀胱健康。

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.