MENTORED CLINICAL SCIENTIST DEVELOPMENT AWARD

这个职业发展计划的总体目标是在罗切斯特大学医学院建立一个独立的儿童肥胖流行病学研究项目。在美国，超重和肥胖的患病率正在上升，特别是在社会经济地位低的女性和少数种族/民族中。怀孕被描述为一种生活事件，在这种情况下，体重可能会增加并随后保持。因此，研究和培训活动将集中于查明不同种族/族裔群体的青少年和年轻人妊娠期体重增加和产后体重保持的独立和共同决定因素，作为妇女超重和肥胖的主要决定因素。具体目标是：1）建立系统的青少年营养与行为、怀孕青少年特殊营养需求、怀孕与非怀孕青少年营养状况测量、纵向和多水平数据统计分析、社区水平变量测量与分析等方面的培训计划; 2）分析生物学、社会人口学、行为学、和社区水平的妇女怀孕体重增加和产后体重保持的决定因素，来自纽约州地区围产期数据系统和年轻成人冠状动脉风险发展研究（CARDIA）; 3）设计一项针对青少年和年轻人的观察性前瞻性研究，以确定少数种族/民族中妊娠体重增加和产后体重保持的生物学、行为学、社会人口学、心理学和社区水平决定因素。拟议的职业发展活动涉及以下方面的培训：身体组成的测量和解释;青少年的生殖、行为/心理健康、营养和健康生活方式问题;负责任的研究行为;以及纵向和定性数据分析。在培训计划结束时，候选人将成为儿科营养流行病学领域的独立调查员。这项建议的临床和公共卫生意义是基于医学研究所的一份报告，该报告表明，非洲裔美国妇女和青少年在怀孕期间增加的体重超过了建议的体重增加量，这是文献中关于怀孕期间保持体重增加对青少年健康风险的警告，以及减少美国人健康差距的国家目标。此外，缺乏关于不同社会经济和种族/族裔少数群体青少年怀孕体重增加和产后体重保持的不同决定因素的经验性纵向数据。检查生物，社会文化和社区层面的因素，可能会有所不同的特定人群亚群成为相关的，以定制的战略，防止产后体重保留，而不威胁母亲或新生儿的健康。 鉴于肥胖对健康的不良影响，以及维持减肥的困难，肥胖的初级预防对公共卫生特别重要。

The overall goal of this career development plan is to establish an independent research program in the epidemiology of obesity in children at the University of Rochester School of Medicine. Prevalences of overweight and obesity are rising in the United States, especially among females of low socioeconomic status and racial/ethnic minorities. Pregnancy has been described as a life event in which excessive weight can be gained and subsequently retained. Thus, research and training activities will concentrate on the identification of the independent and joint determinants of gestational weight gain and post-partum weight retention in adolescents and young adults of different racial/ethnic groups as major determinants of overweight and obesity in women. The specific aims are: 1) To establish a systematic training program in adolescent nutrition and behavior, special nutritional needs of pregnant adolescents, measurement of nutritional status in pregnant and non-pregnant adolescents, statistical analysis of longitudinal and multi-level data, and measurement and analysis of community-level variables; 2) To analyze cross-sectional and longitudinal data on biological, sociodemographic, behavioral, and community-level determinants of pregnancy weight gain and post-partum weight retention m women from the New York State Regional Perinatal Data System and the Coronary Artery Risk Development in Young Adults study (CARDIA); 3) To design an observational prospective study of adolescents and young adults to identify the biological, behavioral, sociodemographic, psychological, and community-level determinants of pregnancy weight-gain and post-partum weight retention among racial/ethnic minorities. The proposed career development activities involve training in the measurement and interpretation of body composition; in reproductive, behavioral/mental health, and nutrition and healthy lifestyle issues in adolescents; in Responsible Conduct of Research; and in longitudinal and qualitative data analysis. At the end of the training program, the candidate will be an independent investigator in the field of pediatric nutrition epidemiology. The clinical and public health significance of this proposal are based on a report from the Institute of Medicine suggesting that African-American women and adolescents gain in the upper end of the recommended weight-gain during pregnancy, a warning in the literature as to the health risks to young adolescents of retaining weight gained during pregnancy, and a national goal of reducing health disparities among Americans. In addition, there is a scarcity of empirical longitudinal data on the differential determinants of pregnancy weight-gain and post-partum weight retention in adolescents of various socioeconomic and racial/ethnic minorities. Examining biological, sociocultural, and community-level factors that may differ among specific population subgroups becomes relevant in order to tailor strategies which prevent post-partum weight retention without threatening either the mother's or the newborn's health. Given the adverse health effect of obesity and the difficulties involved in maintaining weight loss, primary prevention of obesity is of particular public health importance.