Maintenance of Ideal Cardiovascular Health across the Life Course in Women

 描述(由申请者提供)：这个以患者为导向的K23职业发展奖将为候选人提供必要的培训和研究经验，以启动专注于女孩和妇女心血管疾病早期预防的独立研究生涯。最近的研究发现，在那些能够达到中年并拥有一系列被称为理想心血管健康的生理和行为因素的女性中，心血管疾病的发病率和死亡率显著降低。然而，人们对早期的因素知之甚少，这些因素对成年后保持理想的心血管健康特别重要，或者特别是在女性中。通过使用一种在两个年龄范围重叠的流行病学队列中创建序贯风险预测模型的新技术，候选人将量化青春期和成年早期关键生命阶段中促进心血管健康的行为、生理和心理因素的相对重要性。[候选人将进行定性研究，以确定促进两项队列研究中确定的行为的发展适当战略。然后，候选人将准备编写一个R01应用程序，重点是开发和评估有针对性的行为干预措施，以促进来自各种种族/民族背景的青少年和年轻成年女性的理想健康。]培训计划将支持研究战略的所有方面，并利用纵向队列分析和定性研究战略为独立研究职业生涯做好独特的准备，以提供以患者为导向的行为干预措施。课程、指导团队和研究经验旨在提供1)生命过程和慢性病流行病学的协同培训，2)研究生命过程中关键窗口的统计方法，以及3)[为设计适合发展的行为干预措施提供信息的以患者为导向的健康传播研究]。哈佛公共卫生学院、哈佛教育研究生院、哈佛促进会和波士顿儿童医院在这三个领域都提供了无与伦比的环境。候选人组建了一支具有心血管流行病学、儿童和青少年健康、纵向队列分析、焦点小组方法、定性数据分析以及与弱势群体的健康沟通和健康促进方面的专业知识的指导团队。在这个团队的指导下，候选人将非常适合实现她当前的职业目标，即进一步加强以患者为导向的研究和心血管流行病学方面的培训，确定年轻女性生活中维持心血管健康的关键窗口，并将这些发现转化为青年心血管健康促进战略。[培训活动和结果将成为提交R01提案的依据，这些提案旨在针对少女和年轻妇女的独特需要进行行为干预试验，并对幼儿和围产期的心血管健康促进因素进行流行病学研究。]最终，候选人的目标是加深对与在整个生命过程中维持心血管健康相关的因素的理解，并设计新的有效干预措施，以增强与心血管疾病风险相关的积极因素和抵消消极因素。

 DESCRIPTION (provided by applicant): This patient-oriented K23 Career Development Award will provide the candidate with the training and research experience essential to launch an independent research career focused on the early prevention of cardiovascular disease in girls and women. Recent research has identified substantially lower cardiovascular morbidity and mortality in those women able to reach middle age with a constellation of physiologic and behavioral factors known as ideal cardiovascular health. However, little is known about earlier factors that are particularly salient for the maintenance of ideal cardiovascular health into adulthood in general or in women specifically. By using a novel technique of creating sequential risk prediction models in two epidemiologic cohorts with overlapping age ranges, the candidate will quantify the relative importance of cardiovascular health-promoting behavioral, physiologic, and psychological factors during the critical life stages of adolescence and early young adulthood. [The candidate will conduct qualitative studies to identify developmentally appropriate strategies for promotion of behaviors identified in the two cohort studies. The candidate will then be poised to write an R01 application focused on developing and evaluating targeted behavioral interventions for promoting ideal health among adolescent and young adult women from a variety of racial/ethnic backgrounds.] The training plan will support all aspects of the research strategy and uniquely prepare the candidate for an independent research career using longitudinal cohort analyses and qualitative research strategies to inform cutting edge patient-oriented behavioral interventions. The coursework, mentorship team, and research experiences are designed to provide synergistic training in 1) life course and chronic disease epidemiology, 2) statistical methods for studying critical windows in the life course, and 3) [patient-oriented health communications research that informs the design of developmentally appropriate behavioral interventions]. The Harvard School of Public Health, Harvard Graduate School of Education, Harvard Catalyst, and Boston Children's Hospital all offer unparalleled environments in these three areas. The candidate has assembled a mentorship team with expertise in cardiovascular epidemiology, child and adolescent health, longitudinal cohort analysis, focus group methodology, qualitative data analysis, and health communication and health promotion with vulnerable populations. Mentored by this team the candidate will be well-suited to achieve her immediate career goals of furthering her training in patient-oriented research and cardiovascular epidemiology, identifying critical windows in the lives of young women for cardiovascular health maintenance, and translating these findings to cardiovascular health promoting strategies in youth. [Training activities and results will inform submission of R01 proposals to conduct trials of behavioral interventions aimed at the unique needs of adolescent girls and young women and to conduct epidemiologic studies of cardiovascular health promoting factors in early childhood and the peri-natal period.] Ultimately the candidate's goals are to deepen the understanding of factors related to the maintenance of cardiovascular health throughout the life course and to design novel and effective interventions that enhance positive factors and counterbalance negative factors related to cardiovascular disease risk.