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

简介(申请人提供)：我自1998年以来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工作，后来从事临床干预研究。在接下来的七年里，在完成研究生学业的同时，我过渡到了基于社区的研究和公共卫生传播项目。我对这个领域有着深厚的热情和承诺，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2500多名领导人实施针对中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专职科学家和项目主任，也是集团健康研究所女性健康和老龄化方面的博士后研究员。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。我培训的主要内容将包括获得空间分析、地理信息系统和建筑环境评估方面的专业知识；基于社区的参与性研究；先进的量化方法；以及进行负责任的研究。培训活动与我的研究计划直接相关，该计划旨在了解长期的健康行为维持。我们知道，保持身体活动和健康饮食对保持减肥和降低心血管疾病(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心血管疾病相关的健康行为。壮女健康心脏(SWHH)是一个为期12周的社区计划，目标是中老年农村妇女，该计划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。SWHH计划由疾控中心提供资金，以评估其在全国的传播情况。在我的研究中，我将在实施一年后与SWHH的参与者和领导者进行跟踪调查，检查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、实施和评估已建成环境评估工具。总而言之，这些数据将提供一个与长期保持健康饮食和体育活动有关的个人、社会和建筑环境因素的综合模型。我计划提交后续的R01，作为我正在进行的研究计划的一部分，随着时间的推移跟踪这个队列。我的长期目标是将自己确立为该领域的独立研究员和领导者，专注于以理论为导向、以社区为基础的体力活动和营养研究，旨在预防服务不足的人群中的心血管疾病和其他慢性病，以及推动与食物获取、建筑环境和社会经济因素对健康的影响相关的实践和政策的战略。我将通过卓越的导师指导、翻译和参与性研究以及参与式服务来分享这些知识。该奖项的培训、指导和研究将极大地推进我实现这些目标的道路。 与公共健康相关：心脏病是美国女性死亡的主要原因，在农村、低收入和少数族裔人群中风险增加-但如果坚持健康的生活方式，它基本上是可以预防的。这项工作建立了强大的女性健康心脏(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身体活动行为相关的关键因素，这将有助于确定以证据为基础的干预战略，以支持可持续的生活方式改变。此外，该项目将开发、实施和评估体力活动和营养建立的环境评估工具，社区成员和科学研究人员可以利用这些工具在未来与其他高危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.