Speaking Their Language: Using Social Media and Texting to Create an Adolescent-Centered Approach to Healthy Weight Gain During Pregnancy

 描述(申请人提供)：Tammy Chang，医学博士，公共卫生硕士，硕士，家庭医生和初级临床调查员，专注于减少青少年母亲和她们的孩子的肥胖。张博士的长期职业目标是使用量身定制的电子健康技术减少低收入青少年母亲的健康差距。这个K23指导职业发展奖的目标包括一项为期5年的培训和研究活动计划，该计划将提供成为一名成功的独立调查员所需的技能和经验。研究背景：美国是发达国家中青少年怀孕率最高的国家之一；大多数怀孕的青少年在怀孕期间体重超标。过多的妊娠体重增加对青春期母亲的健康有严重的负面影响，增加了分娩过程中危险并发症的风险，并导致母亲和孩子长期肥胖。认识到这一重要的人口健康问题，国际移民组织和AHRQ都将针对妊娠超重增加的干预措施的开发确定为主要的研究重点。与成年人相比，人们对青少年怀孕体重增加的了解相对较少。因此，迫切需要了解青少年对怀孕体重增加的看法和知识，以便研究人员可以定制干预措施，使其与怀孕的青少年相关。这项建议的短期目标是获得必要的技能，以开发以青少年为中心的定制电子健康干预措施，以减少过度怀孕体重增加。具体目标：1)确定哪些美国怀孕青少年(年龄≤21岁)显著超重妊娠体重增加的高风险；2)确定影响青少年超重妊娠体重增加的基本知识、信念和因素；3)设计和测试针对高危怀孕青少年量身定做的可扩展的健康饮食和运动电子健康干预措施。研究计划：为了实现这些目标，常博士将使用来自脆弱家庭和福祉研究的具有全国代表性的数据进行分析；对怀孕和产后的青少年进行社交媒体挖掘和相应的定性访谈；并设计、实施和评估以青少年为中心的量身定制的电子健康(定制短信)干预措施。职业发展计划：张博士将使用具有全国代表性的大型数据集拓宽她对先进统计方法的知识；培养挖掘和分析在线社交媒体数据的技能；获得针对怀孕青少年量身定做的可扩展干预措施的设计、实施和评估方面的专业知识；以及在将研究成果转化为临床相关政策和实践方面获得经验。张博士的职业发展目标将通过以下方式得到支持：一个跨学科团队的密切指导；一个专家咨询小组的指导；高级教学课程工作；出席专业会议和研讨会；参加研讨会和期刊俱乐部；指导手稿准备和为她作为本提案一部分进行的研究产生的项目制定拨款提案；以及实施她的研究计划。这项培训将直接促进张博士的目标，即解决高危青少年中怀孕体重过度增加这一关键的代际问题，以及随后提交成功的R01申请。环境：张博士独一无二的资源包括她之前与之合作过的敬业和成就卓著的多学科导师团队；密歇根大学和家庭医学系卓越的研究基础设施，特别强调支持初级研究人员；以及由密歇根大学几个不同学术单位提供的许多高级教学课程和研讨会。

 DESCRIPTION (provided by applicant): Tammy Chang, MD, MPH, MS is a family physician and junior clinical investigator focused on reducing obesity among adolescent mothers and their children. Dr. Chang's long-term career objective is to reduce health disparities among low-income adolescent mothers using tailored eHealth technologies. The objective of this K23 mentored career development award includes a 5-year plan for training and research activities that will provide the skills and experiences needed to become a successful independent investigator. RESEARCH CONTEXT: The United States (US) has one of the highest adolescent pregnancy rates in the developed world; the majority of pregnant adolescents gain excess weight during pregnancy. Excess pregnancy weight gain has a significant negative impact on the health of the adolescent mother, increases the risk of dangerous complications during delivery, and contributes to long-term obesity for both mother and child. In recognition of this important population health problem, both the IOM and AHRQ have identified the development of interventions targeting excess pregnancy weight gain as a major research priority. Compared to adults, relatively little is known about pregnancy weight gain among adolescents. Therefore, there is a critical need to understand adolescents' perceptions of and knowledge about pregnancy weight gain, so that researchers can customize interventions and make them relevant to the pregnant adolescent. The short-term goal of this proposal is to acquire the requisite skills to develop an adolescent-centered tailored eHealth intervention to reduce excess pregnancy weight gain. SPECIFIC AIMS: 1) Determine which US pregnant adolescents (aged ≤21 years) are at high risk for significant excess pregnancy weight gain; 2) Identify the baselin knowledge, beliefs, and factors that influence excess pregnancy weight gain among adolescents; and 3) Design and test a scalable healthy diet and exercise eHealth intervention tailored to at-risk pregnant adolescents. RESEARCH PLAN: To accomplish these aims, Dr. Chang will conduct analyses using nationally representative data from the Fragile Families and Wellbeing Study; carry out social media mining and corresponding qualitative interviews with pregnant and postpartum adolescents; and design, implement, and evaluate an adolescent- centered and tailored eHealth (tailored text-messaging) intervention. CAREER DEVELOPMENT PLAN: Dr. Chang will broaden her knowledge of advanced statistical methods using a large nationally representative dataset; develop skills in mining and analyzing online social media data; acquire expertise in designing, implementing, and evaluating scalable interventions tailored to pregnant adolescents; and obtain experience in translating research findings into clinically relevant policies and practices. Dr. Chang's career development goals will be supported through close mentorship from an interdisciplinary team; guidance from an expert advisory panel; advanced didactic course work; attendance at professional meetings and workshops; participation in seminars and journal clubs; guidance in manuscript preparation and grant proposal development for projects arising from the research she conducts as part of this proposal; and implementing her research plan. This training will directly contribute to Dr. Chang's goal of addressing a vital intergenerational problem of excess pregnancy weight gain among at-risk adolescents, as well as the subsequent submission of a successful R01 application. ENVIRONMENT: Dr. Chang's unique resources include a dedicated and accomplished multi-disciplinary mentorship team with whom she has previously collaborated; the outstanding research infrastructure at the University of Michigan and Department of Family Medicine with a particular emphasis on supporting junior investigators; and numerous advanced didactic courses and seminars provided by several distinct academic units at the University of Michigan.