MENTORED CLINICAL SCIENTIST DEVELOPMENT AWARD

这个职业发展计划的总体目标是在罗彻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，尤其是在社会经济地位较低的女性和少数种族/民族中。怀孕被描述为一个生命事件，在此期间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确定不同种族/族裔群体的青少年和青年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、怀孕少女特殊营养需求、怀孕与非怀孕少女营养状况测量、纵向与多层次数据统计分析、社区层面变量测量与分析等方面的培训方案；2)分析来自纽约州区域围产期数据系统和年轻人冠状动脉风险发展研究（CARDIA）的女性孕期体重增加和产后体重保持的生物学、社会人口学、行为和社区水平决定因素的横断面和纵向数据；3)设计一项针对青少年和年轻成人的观察性前瞻性研究，以确定少数种族/民族怀孕体重增加和产后体重保持的生物学、行为、社会人口学、心理和社区水平的决定因素。拟议的职业发展活动包括身体组成的测量和解释方面的培训；青少年的生殖、行为/心理健康以及营养和健康生活方式问题；负责任的研究行为；在纵向和定性数据分析中。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。这项提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体重增加的上限，文献中警告年轻青少年在怀孕期间保持体重增加的健康风险，以及减少美国人之间健康差距的国家目标。此外，关于不同社会经济和种族/民族少数群体青少年孕期体重增加和产后体重保持的差异决定因素的经验纵向数据缺乏。检查在特定人群亚群中可能存在差异的生物、社会文化和社区层面的因素，对于制定预防产后体重潴留的策略而不威胁母亲或新生儿的健康具有重要意义。鉴于肥胖对健康的不利影响以及维持体重减轻所涉及的困难，预防肥胖对公共卫生具有特别重要的意义。

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.