The StrongWomen Healthy Hearts Follow-up Study: Individual, leadership, and built

描述（由申请人提供）：自1998年以来，我一直在运动生理学和营养学领域工作，最初专注于心肺康复的临床研究，后来从事临床干预研究。在随后的七年里，在完成研究生学业的同时，我转向了以社区为基础的研究和公共卫生传播项目。我对这一领域有着深厚的热情和承诺，并致力于与服务不足的人群合作;这项工作的一部分涉及培训和支持全国2,500多名领导人实施针对中年和老年农村妇女的社区体育活动和营养计划。目前，我是弗雷德哈钦森癌症研究中心的科学家和项目主任，也是团体健康研究所妇女健康和老龄化的博士后研究员。对于这个职业发展奖，我很幸运地得到了来自顶级研究机构的顶尖专家的支持-担任导师，共同导师和顾问。我的培训的主要组成部分将包括获得空间分析，地理信息系统和建筑环境评估的专业知识;以社区为基础的参与式研究;先进的定量方法;和负责任的研究行为。培训活动与我的研究计划直接相关，该计划旨在了解长期健康行为的维持。 我们知道，保持身体活动和健康饮食对于保持体重减轻和降低心血管疾病（CVD）风险至关重要，但确定长期支持这些行为的关键因素的数据有限。研究还表明，人们生活的食物和身体活动环境会影响与CVD相关的健康行为。StrongWomen Healthy Hearts（SWHH）是一项为期12周的社区计划，针对中年和老年农村妇女，已证明在增加体力活动、改善饮食质量和减轻体重方面有效。疾病预防控制中心为SWHH方案提供资金，以评估其在全国的传播情况。在我的研究中，我将对SWHH参与者和领导者进行后续调查，检查实施一年后与行为维持相关的因素。我还将与SWHH社区合作伙伴一起开发，实施和评估建筑环境评估工具。总的来说，这些数据将为与长期保持健康饮食和体育活动相关的个人，社会和建筑环境因素的综合模型提供信息。我计划提交后续的R 01，以随时间推移跟踪该队列，作为我正在进行的研究计划的一部分。 我的长期目标是建立自己作为一个独立的调查员和在该领域的领导者，专注于理论驱动的，以社区为基础的身体活动和营养研究，以预防心血管疾病和其他慢性疾病在服务不足的人群，和战略，以推进实践和政策相关的食物获取，建筑环境和社会经济因素对健康的影响。我将通过卓越的指导，转化和参与式研究以及参与式服务来分享这些知识。这个奖项的培训，指导和研究将大大推进我实现这些目标的道路。 公共卫生相关性：心脏病是美国女性死亡的主要原因，农村、低收入和少数民族人群的风险增加，但通过坚持健康的生活方式行为，它在很大程度上是可以预防的。这项工作建立了StrongWomen Healthy Hearts（SWHH）后续研究，以了解与中老年农村妇女长期保持健康饮食和体育活动行为相关的关键因素，这将有助于确定基于证据的干预策略，以支持可持续的生活方式改变。此外，该项目将开发，实施和评估身体活动和营养建成环境评估工具，社区成员和科学调查人员可以利用这些工具在未来与其他高风险人群一起推进这项工作。

DESCRIPTION (provided by applicant): I have been working in the field of exercise physiology and nutrition since 1998, beginning with a clinical focus in cardiac and pulmonary rehabilitation and later working in clinical intervention research. For the subsequent seven years, while completing graduate school, I transitioned to community-based research and public health dissemination projects. I have a deep passion and commitment to this field and to working with underserved populations; part of this work has involved training and supporting more than 2,500 leaders nationally to implement community physical activity and nutrition programs targeted to midlife and older rural women. Currently, I am a staff scientist and project director at the Fred Hutchinson Cancer Research Center and a postdoctoral fellow in women's health and aging at the Group Health Research Institute. For this career development award, I am fortunate to have support of leading experts from top-tier research institutions- serving as mentor, co-mentor, and advisors. The main components of my training will include gaining expertise in spatial analysis, GIS, and built environment assessment; community-based participatory research; advanced quantitative methods; and conduct of responsible research. The training activities are directly related to my research plan, which aims to gain understanding about long-term health behavior maintenance. We know that maintenance of physical activity and healthy eating is essential to maintain weight loss and reduce risk for cardiovascular disease (CVD), yet there are limited data identifying key factors that support the behaviors long-term. Research also shows that the food and physical activity environments in which people live affect health behaviors related to CVD. StrongWomen Healthy Hearts (SWHH) is a 12-week community-based program targeted to midlife and older rural women that has demonstrated effectiveness in increasing physical activity, improving diet quality, and decreasing body weight. The SWHH Program has funding from the CDC to evaluate its dissemination nationally. For my research, I will conduct a follow-up survey with SWHH participants and leaders examining factors related to behavior maintenance one year following implementation. I will also develop, implement, and evaluate built environment assessment tools with SWHH community partners. Collectively, these data will inform a comprehensive model of personal, social, and built environment factors related to long-term maintenance of healthy eating and physical activity. I plan to submit a subsequent R01 to follow this cohort over time as part of my ongoing research program. My long-term objectives are to establish myself as an independent investigator and a leader in the field, focusing on theory-driven, community-based physical activity and nutrition research targeting the prevention of CVD and other chronic diseases in underserved populations, and strategies to advance practice and policy related to the effects of food access, built environment, and socioeconomic factors on health. I will share this knowledge through excellence in mentorship, translational and participatory research, and engaged service. The training, mentorship, and research for this award will greatly advance my path to achieve these objectives. PUBLIC HEALTH RELEVANCE: Heart disease is the leading cause of death among women in the U.S., with increased risk among rural, low-income, and minority populations - yet it is largely preventable with adherence to healthy lifestyle behaviors. This work establishes the StrongWomen Healthy Hearts (SWHH) follow-up study to gain understanding about key factors that are related to the long-term maintenance of healthy eating and physical activity behaviors among midlife and older rural women, which will help identify evidence-based intervention strategies to support sustainable lifestyle changes. Additionally, this project will develop, implement, and evaluate physical activity and nutrition built environment assessment tools that community members and scientific investigators can utilize to advance this work with other high-risk populations in the future.