Pathways to LUTS Prevention: A Model for Public Education, Behavioral Skills, and Early Detection

LUTS 预防途径：公共教育、行为技能和早期检测的模型

• 批准号: 9124876
• 负责人: KATHRYN Larsen BURGIO
• 金额: $ 51.33万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9124876
• 关键词: Address; Affect; Age; Aging; Alabama; Attitude; Behavior Therapy; Behavioral; Behavioral Sciences; Biofeedback; Bladder; Bladder Control; Cellular Phone; Clinical; Clinical Trials; Clinical Trials Design; Cohort Studies; Collaborations; Data; Data Set; Databases; Detection; Development; Discipline of Nursing; Early Diagnosis; Early Intervention; Educational process of instructing; Effectiveness; Epidemiologic Studies; Epidemiology; Esthesia; Evaluation; Exercise; Factor Analysis; Foundations; Frequencies; Functional disorder; Funding; Future; Geriatrics; Gynecology; Habits; Health; Health behavior; Incidence; Incontinence; Increased frequency of micturition; Individual; Internet; Interstitial Cystitis; Intervention; Intervention Trial; Knowledge; Learning; Literature; Longevity; Longitudinal Studies; Misinformation; Modeling; National Health and Nutrition Examination Survey; National Heart, Lung, and Blood Institute; National Institute of Child Health and Human Development; National Institute of Diabetes and Digestive and Kidney Diseases; Nocturia; Online Systems; Operative Surgical Procedures; Overactive Bladder; Pathway interactions; Patients; Pelvic Floor Disorders; Pelvic Floor Muscle; Pelvic floor structure; Perioperative; Play; Prevalence; Prevention; Prevention strategy; Prevention trial; Preventive Intervention; Preventive Medicine; Prostatectomy; Provider; Public Health; Radical Prostatectomy; Randomized Controlled Trials; Readiness; Rehabilitation therapy; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Self-Administered; Severities; Site; Surveys; Symptoms; Techniques; Testing; Time; Training; United States National Institutes of Health; Universities; Urinary Incontinence; Urology; Veterans; Woman; Women' s Health; Women' s Health Services; Work; base; clinically relevant; diet and exercise; effective therapy; evidence base; interest; lower urinary tract symptoms; men; pelvic organ prolapse; prevent; programs; prospective; public education; randomized trial; response; screening; skills; telehealth; young woman

 DESCRIPTION (provided by applicant): Lower urinary tract symptoms (LUTS) encompass a wide range of symptoms including urinary incontinence, urinary frequency, urgency, nocturia, bladder pain syndrome, and symptoms of voiding dysfunction. There is an extensive literature describing the many approaches to treatment of LUTS, but much less is known about prevention. Epidemiological studies have identified numerous risk factors for LUTS, but evidence is lacking for the roles of behavioral factors, including how we learn our bladder habits, whether they affect the risk of developing LUTS, and what defines healthy bladder habits. The primary aim of this proposal is to participate as a Clinical Center in the "Prevention of Lower Urinary Tract Symptoms in Women: Bladder Health Clinical Centers" (PLUS) Research Consortium and work with other centers to examine the existing evidence and plan foundational studies for development of future trials of prevention interventions for LUTS. The University of Alabama at Birmingham (UAB) Continence Team is an interdisciplinary group of investigators from behavioral science, geriatrics, preventive medicine, public health, urogynecology, and urology. Our epidemiological work includes identifying risk factors for incident incontinence using the NIA-funded UAB longitudinal Study of Aging, national VA databases, and risk factor analyses of NHANES data. The depth of the UAB team covers all aspects of LUTS clinical trial design and conduct (including NIH multi-site networks), evaluation and treatment of LUTS in women, and a strong track record of recruitment and retention of both patients and control subjects (including being a Vanguard Center for the NHLBI Women's Health Initiative). The second aim is to address known gaps in current epidemiological knowledge, through a prospective longitudinal cohort study to assess a range of behavioral factors and their effect on the incidence and progression of LUTS. Understanding the roles of bladder health behaviors will support the development of a risk model for identifying individuals and groups at risk for LUTS, as well as inform public education initiatives. The third aim is to conduct foundational studies guided by our conceptual framework to develop three potential pathways to prevention of LUTS: public education initiatives targeted across the lifespan to convey knowledge and dispel myths about healthy bladder habits and LUTS; skill-based interventions for young women and at-risk groups to teach evidence-based behavioral skills and healthy bladder habits; and detection of and self-administered interventions for early LUTS. The plan of studies includes 1) the longitudinal cohort study, which will also provide meaningful content for public education campaigns, 2) a survey of providers to assess feasibility of teaching pelvic floor muscle control and healthy bladder habits to young women at a time of relative readiness - the first gynecology encounter, and 3) developing and pilot testing an internet-based, self-administered behavioral intervention including a smart-phone application as a practical first step in addressing early LUTS. Findings from these studies will lay the foundation for future trials of interventions to prevent LUTS in women across the lifespan.

 描述(申请人提供)：下尿路症状(LUT)包括各种症状，包括尿失禁、尿频、尿急、夜尿、膀胱疼痛综合征和排尿功能障碍症状。有大量的文献描述了治疗LUTS的许多方法，但对预防的了解要少得多。流行病学研究已经确定了许多LUTS的危险因素，但缺乏关于行为因素的作用的证据，包括我们如何学习我们的膀胱习惯， 它们是否会影响发生LUT的风险，以及健康的膀胱习惯是什么。这项建议的主要目的是作为临床中心参与“预防女性下尿路症状：膀胱健康临床中心”(PLUS)研究联盟，并与其他中心合作检查现有证据，并为未来LUTS预防干预试验的发展计划基础研究。阿拉巴马大学伯明翰分校(UAB)大陆团队是一个跨学科的研究小组，研究人员来自行为科学、老年病学、预防医学、公共卫生、泌尿科和妇科。我们的流行病学工作包括使用NIA资助的UAB老龄化纵向研究、国家VA数据库和NHANES数据的风险因素分析来确定偶发性尿失禁的风险因素。UAB团队的深度涵盖了LUTS临床试验设计和实施的方方面面(包括NIH多站点网络)、女性LUTS的评估和治疗，以及招募和保留患者和对照受试者的良好记录(包括成为NHLBI妇女健康倡议的先锋中心)。第二个目标是通过前瞻性纵向队列研究，评估一系列行为因素及其对LUTS的发生和发展的影响，以解决当前流行病学知识中的已知差距。了解膀胱健康行为的作用将有助于开发一种风险模型，以识别有LUTS风险的个人和群体，并为公共教育倡议提供信息。第三个目标是在我们的概念框架指导下进行基础性研究，以制定预防LUTS的三种潜在途径：针对整个生命周期的公共教育举措，以传播关于健康膀胱习惯和LUT的知识并消除神话；针对年轻女性和高危群体的技能干预，以传授循证行为技能和健康的膀胱习惯；以及检测和自我管理早期LUT干预措施。研究计划包括1)纵向队列研究，这也将为公共教育活动提供有意义的内容；2)对提供者进行调查，以评估在相对准备好的时候向年轻女性教授盆底肌肉控制和健康的膀胱习惯的可行性--这是妇科的第一次接触；以及3)开发和试点测试基于互联网的自我管理行为干预，包括智能手机应用，作为解决早期LUT的实际第一步。这些研究的结果将为未来预防女性终身LUTS的干预试验奠定基础。