Postpartum Weight Retention and Cardiometabolic Disparities: The Effects of Contexual, Psychosocial, and Behavioral Factors

项目总结/摘要 了解生育背景下的体重对于解决 肥胖症在美国人口中流行，特别是在女性和各种 种族/民族团体。这项研究将促进我们对可能影响健康的因素的理解。 解释产后体重保持和心脏代谢风险的种族差异， 育龄妇女本研究具有推进方法和评估的双重目的， 怀孕，体重和肥胖，通过应用生态瞬时评估（EMA）， 收集真实的时间数据，并使用智能手机等移动的技术 设备作为收集数据的手段。我们将同时收集压力，情绪， 饮食，身体活动和位置在真实的时间通过智能手机;以及措施， 使用蓝牙秤称重。在真实的时间和她们的真实的 通过现有技术改善环境可能有潜力促进健康，实践， 并减轻妇女和提供者的负担。我们也将有能力确定 孕妇和产后妇女数据收集的最佳时间点和频率 人口 本研究将是Davis GDM 2研究（N=920）的辅助研究（N=350），Davis GDM 2研究是一项 在不同孕妇人群中进行的随机对照试验， 确定两种筛查方法对妊娠结局的差异 糖尿病和代谢风险的母亲和他们的后代。我们将跟踪来自 他们怀孕的最后三个月到九个月，并定期收集EMA评估; 来自GDM 2研究的产后1年数据。 本研究的目的是：（1）确定PPWR从分娩到1年的种族差异 产后，并确定社会心理，行为和上下文/环境因素， 导致种族差异;（2）确定心脏代谢特征的种族差异 (BP、LDL/HDL、血红蛋白A1 C、胰岛素），并确定产后1年的心理社会， 行为和背景/环境因素，导致种族差异， 心脏代谢概况;和（3）探索潜在的行为和心理社会介质的 背景/环境与PPWR/心脏代谢特征之间的关联。 这项研究旨在支持一项长期目标的研究计划，以了解和 消除生育方面体重和肥胖的种族/族裔差异。的 从这项研究中获得的知识将是至关重要的，在有效地发展多层次 旨在减少妇女肥胖的干预措施、方案和政策。此外，委员会认为， 评估怀孕期间和产后的关键时期， 利用移动的技术进行及时干预的新领域。

Project Summary/Abstract Understanding weight in the context of childbearing will be important for addressing the profound obesity epidemic in the US population, particularly among women and various racial/ethnic groups. This research study will advance our understanding of the factors that may explain the racial disparity in postpartum weight retention and cardiometabolic risks among childbearing women. This study has a dual purpose of advancing methods and assessment of pregnancy, weight and obesity by applying ecological momentary assessment (EMA), which is collecting data in real time, and using mobile technology such as smartphones and other devices as a means to collect data. We will simultaneously collect measures of stress, mood, diet, physical activity, and location in real time through smartphones; as well as measures of weight using Bluetooth enabled scales. Assessing women in real time and in their real environment through existing technologies may have the potential to advance health, practice, and reduce the burden on women and providers. We will also have the ability to determine optimal points of time and frequency for data collection among a pregnant and postpartum population. This study will be an ancillary study (N=350) to the Davis GDM2 Study (N=920), which is a randomized controlled trial among a diverse population of pregnant women designed to determine differences in perinatal outcomes for two screening approaches for gestational diabetes and metabolic risk profiles of mothers and their offspring. We will follow women from their last trimester of pregnancy to nine months and collect regular EMA assessments; and link the 1 year postpartum data from the GDM2 Study. The research aims are: (1) Determine the racial disparity in PPWR from delivery through 1 year postpartum and identify the psychosocial, behavioral, and contextual/environmental factors that contribute to the racial disparity; (2) Determine the racial disparity in cardiometabolic profiles (BP, LDL/HDL, hemoglobin A1C, insulin) 1 year after delivery and identify the psychosocial, behavioral, and contextual/environmental factors that contribute to the racial disparity in cardiometabolic profiles; and (3) Explore potential behavioral and psychosocial mediators of the association between context/environment and PPWR/cardiometabolic profiles. This study is intended to support a research program with a long-term goal to understand and eliminate racial/ethnic disparities in weight and obesity in the context of childbearing. The knowledge gained from this study will be critical in effectively developing multilevel interventions, programs and policies aimed at reducing obesity among women. Furthermore, assessing critical periods during pregnancy and postpartum provides insight into developing new areas of just-in-time intervention using mobile technology.