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

项目摘要/摘要 下尿路症状(LUT)包括一系列症状，包括尿失禁、 尿频、尿急、夜尿、膀胱疼痛、尿路感染和排尿症状。有一个 大量文献描述了治疗LUTS的许多方法，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 成立的目的是将研究范围从治疗LUTS扩展到促进膀胱健康和预防 在青少年和妇女的整个生命过程中发生LUTS。尽管有很多关于危险因素的流行病学研究 对于LUTS，很少有研究考察促进膀胱健康的因素。一个关键的差距是对 是什么定义了健康的排尿和如厕行为，以及随着时间的推移，这些行为如何影响膀胱健康。 我们的主要假设是，不适应的排尿和如厕行为会导致较差的膀胱。 青春期和成年妇女的健康。这项提议的主要目的是继续我们的参与 作为PLUS中的临床研究中心，并与其他中心合作设计和实施纵向 一项队列研究，为制定未来促进膀胱健康的预防干预措施奠定了基础 并预防LUTS。阿拉巴马大学伯明翰分校(UAB)团队是一个跨学科的小组， 拥有LUTS临床研究、行为医学、老年医学等专业知识的研究人员， 青春期医学、预防科学、公共卫生、流行病学、生物统计学、健康差距和 医学社会学。我们的团队准备为1)纵向研究的设计和实施提供专业知识， 2)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/没有LUTS的不同样本的参与者，以及5)社区 订婚。第二个目标是建立在纵向队列研究的基础上，以检查两个额外的潜力 膀胱健康和LUT的风险/保护因素是未来干预研究的看似合理的目标。在……里面 除了测试国家队列中的其他一些因素外，我们还建议检查1) 使用面积剥夺指数，在排便和如厕行为方面的社区劣势，以及 2)功能能力与排尿、如厕行为的相关性研究 发炎。了解这些因素的作用将有助于发展模型，以确定在- 对个人和群体进行风险评估，并为教育活动提供信息。第三个目标是发展和开展 与促进健康排尿和如厕行为相关的试点基础研究。第一项研究旨在 了解使用移动应用程序的青少年在各种环境中的排尿和如厕行为 用地理信息系统测绘。第二个目标是开发一种移动健康自我管理 促进健康膀胱行为的教育计划。这些项目将为 关于促进整个生命过程中膀胱健康的干预措施的未来研究进展。

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.