Pregnancy and beyond: windows into disparities in women's cardiovascular health

 描述(申请人提供)：心血管疾病是美国女性死亡的主要原因，也是女性健康中种族/民族和社会经济差异的主要来源。我们对哪些生物、行为和心理社会因素对女性简历健康的差异有最大的影响，在我们的理解上存在着根本性的差距。特别是，尽管越来越多的证据表明怀孕可以作为了解女性晚年简历健康的窗口，但很少有工作利用这一窗口来洞察种族或SES在简历健康方面的差异。因此，这项提案的总体目标是确定从怀孕到整个生命过程的各种因素，以及导致女性晚年履历健康的种族/族裔和社会经济差异的因素。拟议的工作将利用POUCHMom研究(2011-2014，n=678)，这是一个独特的纵向队列，包括详细的访谈数据和生命过程中三个关键时期的生物样本--怀孕前(怀孕时进行回顾评估)、怀孕和中年(怀孕后7-15年内进行一次评估)--在种族和社会经济上都是多样化的。这项拟议工作的第一个具体目标是确定生物学、行为和心理社会影响领域内的因素，这些因素可以在怀孕或中年时测量，并导致中年女性CV健康指标(即血压、HTN和HTN前、风险评分和内中膜厚度)的种族和SES差异。虽然可以从现有的POUCHMom数据中获得重要的知识，但对这些妇女进行持续、更频繁和更少负担的跟踪调查对于跟踪生命过程中心血管风险的发展和了解导致种族和SES差异的因素的时间顺序是至关重要的。因此，第二个具体目标是开发和试点创新方法，以 正在使用社交媒体和移动技术在POUCHMom队列中收集数据。候选人Claire Margerison-Zilko博士是密歇根州立大学(MSU)的流行病学助理教授，他为该奖项带来了在社会和围产期流行病学和健康差距研究方面的丰富培训和研究经验。拟议的NHLBI辅导职业发展奖(K01)将为Margerison-Zilko博士提供以下方面的额外培训：1)心血管流行病学和病理生理学，特别是与怀孕期间妇女健康有关的；2)慢性病研究的生命过程方法；3)在健康研究中使用社交媒体和移动技术。这些领域的培训和指导与拟议的研究活动相结合，将使Margerison-Zilko博士能够实现她的长期目标，即建立一个独立和创新的研究计划，研究女性心血管(CV)健康方面的种族/民族和社会经济差异，重点是了解怀孕和CV健康之间的关系。

 DESCRIPTION (provided by applicant): Cardiovascular (CV) disease is the leading cause of death among women in the US and a major source of racial/ethnic and socioeconomic disparities in women's health. There is a fundamental gap in our understanding of which biological, behavioral, and psychosocial factors contribute most to disparities in women's CV health. In particular, despite growing evidence that pregnancy can serve as a window into women's later-life CV health; little work has taken advantage of this window to gain insight into race or SES disparities in CV health. The overall goal of this proposal is therefore to identify factors-from pregnancy and across the life-course-and that contribute to racial/ethnic and socioeconomic differences in women's later-life CV health. The proposed work will take advantage of the POUCHMoms study (2011-2014, n=678), a unique longitudinal cohort that includes detailed interview data and biologic samples from 3 key periods in the life- course-pre-pregnancy (assessed retrospectively at pregnancy), pregnancy, and mid-life (assessed once within 7-15 years post-pregnancy)-and is both racially and socioeconomically diverse. The first specific aim of the proposed work is to identify factors within the domains of biology, behavior, and psychosocial influences that can be measured at pregnancy or mid-life and that contribute to race and SES differences in women's CV health indicators (i.e., blood pressure, HTN and pre-HTN, risk scores, and intima-media thickness) at mid-life. Although important knowledge can be gained from the existing POUCHMoms data, continued, more frequent, and less burdensome follow-up of these women is essential to track development of CV risk over the life- course and to understand the temporal ordering of factors contributing to race and SES disparities. Therefore, the second specific aim is to develop and pilot test innovative methods for ongoing data collection in the POUCHMoms cohort using social media and mobile technology. The candidate, Dr. Claire Margerison-Zilko, is an Assistant Professor of Epidemiology at Michigan State University (MSU) and brings to the award strong training and research experience in social and perinatal epidemiology and health disparities research. The proposed NHLBI Mentored Career Development Award (K01) will provide Dr. Margerison-Zilko with additional training in 1) cardiovascular epidemiology and pathophysiology, especially as it relates to women's health during pregnancy; 2) life course approaches to chronic disease research; and 3) use of social media and mobile technologies in health research. The training and mentoring in these areas combined with the proposed research activities will enable Dr. Margerison-Zilko to achieve her long-term goal of building an independent and innovative research program examining racial/ethnic and socioeconomic disparities in women's cardiovascular (CV) health, with a focus on understanding relations between pregnancy and CV health.