Preclinical Cardiovascular Disease among Adolescents and Young Adults in Haiti

项目摘要 Lindsey Reif博士是一位全球健康流行病学家，其职业目标是利用流行病学研究， 为感染艾滋病毒的青少年和年轻人实施高效健康干预措施。超过 在过去的十年中，她发表了10篇第一作者论文，重点是评估健康结果， 在海地的“青少年-维护健康”协会中采取干预措施。AYALH在艾滋病毒的肆虐下幸存了几十年， 合并症，特别是心血管疾病（CVD），因为他们年龄到成年。K 01的目标是 扩大她的培训和研究，重点关注艾滋病毒相关的临床前心血管疾病-无症状心血管代谢 异常表明AYALH中CVD的发病。她将调整基于证据的干预措施， 预防早发性CVD，对整个生命过程中的AYALH产生影响。 她的培训目标是建立以下方面的专业知识：1）AYALH中的CVD流行病学，2）混合方法， 和3）实施科学，以设计和实施干预措施，以预防心血管疾病的发病率， mortality.她的职业发展计划包括来自一个团队的多学科指导， 在AYALH、艾滋病毒和心血管疾病流行病学以及实施科学方面有数十年的研究经验 在全球健康环境中。该团队在全球卫生领域有着无可挑剔的指导记录 research.赖夫博士还将采取补充先进的课程，以支持她的培训目标。她 K 01由强大的研究和培训环境提供支持，该环境利用了40年的合作 威尔康奈尔（纽约）和GHESKIO（海地）之间。 Reif博士的研究计划在AYALH人群中建立了临床前CVD的流行病学， 循证干预，以预防临床前CVD的发作及其进展。她将主持一个 在500名18-30岁的HIV阳性和500名HIV阴性参与者中进行的前瞻性队列研究， 海地.在目标1中，她将评估临床前CVD的患病率、发病年龄和进展（临床前CVD）。 高血压、微量白蛋白尿和血脂异常）。她将在3年内评估风险因素 领域：生活方式、艾滋病毒相关和心理社会。她假设由艾滋病毒驱动的风险因素集群- 相关和心理社会因素与AYALH中的临床前CVD相关。在目标2中，她将适应 世卫组织HEARTS循证技术包，采用混合方法， 执行科学。本K 01解决了临床前CVD流行病学的知识差距， AYALH，并告知基于证据的心血管疾病干预措施的适应，以防止过早残疾， 在这个群体进入成年期时死亡。Reif博士的培训和职业发展计划 补充和扩展她现有的技能，并最终提交NIH R 01，以帮助她 转型为独立调查员。

PROJECT SUMMARY Dr. Lindsey Reif is a global health epidemiologist with a career goal to leverage epidemiologic research to implement high-impact health interventions for adolescents and young adults living with HIV (AYALH). Over the past decade, she has published 10 first-author papers focused on evaluating health outcomes and interventions among AYALH in Haiti. AYALH, who have survived decades of HIV, now face HIV-related comorbidities, specifically cardiovascular disease (CVD), as they age into adulthood. Her K01 objective is to expand her training and research to focus on HIV-related preclinical CVD— asymptomatic cardiometabolic abnormalities indicating the onset of CVD—among AYALH. She will adapt evidence-based interventions to prevent early onset CVD with impact for AYALH across the lifecourse. Her training objectives are to build expertise in: 1) CVD epidemiology among AYALH, 2) mixed-methods, and 3) implementation science in order to design and implement interventions to prevent CVD morbidity and mortality. Her career development plan includes multidisciplinary mentorship from a team that brings decades of experience in research among AYALH, HIV and CVD epidemiology, and implementation science across global health settings. The team has an impeccable track record of mentorship in global health research. Dr. Reif will also take complementary advanced coursework to support her training objectives. Her K01 is supported by a robust research and training environment that leverages a 40-year collaboration between Weill Cornell (New York) and GHESKIO (Haiti). Dr. Reif’s research plan establishes the epidemiology of preclinical CVD among AYALH and adapts an evidence-based intervention to prevent the onset of preclinical CVD and its progression. She will conduct a prospective cohort study among 500 HIV+ and 500 HIV- participants ages 18-30 years, followed for 3 years in Haiti. In Aim 1, she will evaluate the prevalence, age of onset and progression of preclinical CVD (pre- hypertension, microalbuminuria, and dyslipidemia) by HIV serostatus. She will evaluate risk factors in 3 domains: lifestyle, HIV-related, and psychosocial. She hypothesizes clusters of risk factors, driven by HIV- related and psychosocial factors, are associated with preclinical CVD among AYALH. In Aim 2, she will adapt the evidence-based WHO HEARTS technical package for AYALH in LICs using mixed methods and implementation science. This K01 addresses the knowledge gap of the epidemiology of preclinical CVD among AYALH and informs the adaptation of evidence-based CVD interventions to prevent premature disability and death among this population as they emerge into adulthood. Dr. Reif’s training and career development plan complement and expand her existing skillset and culminate in the submission of an NIH R01 facilitating her transition to independent investigator.