Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery

 描述（由申请人提供）：该计划项目，“弥合产后骨盆底支持和阴道分娩后症状的物理和文化决定因素”使用混合方法研究腹内压，体力活动和力量对骨盆底支持和症状的影响以及妇女经历这些变化的文化背景。多达七分之一的女性在其一生中接受盆腔器官脱垂或尿失禁手术。尽管这些疾病的发病率高，治疗费用高，迫切需要的预防战略是稀缺的，反映了目前的知识状况。在特殊的机构环境和强大的研究基础设施的支持下，该计划项目具有独特的优势，可以解决其主要假设，即了解与首次阴道分娩后的盆底支持和症状相关的因素将导致开发和测试新的预防策略。在这项混合方法研究中，来自4所犹他州大学的11名研究人员组成的核心小组将在犹他州大学丰富的卓越传统基础上，在涉及孕妇或产后妇女、生物工程、运动科学、定性研究和盆底疾病的研究中，共同解决继续困扰盆底疾病研究的问题。该项目的范围与NICHD内妇科健康和疾病分支的组合有关，具体包括骨盆底疾病。该计划的目的是为人性化的循证干预奠定基础，减轻阴道分娩对盆底支持和症状恶化的影响，着眼于早期发现，预防未来令人烦恼的盆底疾病，并提供文化敏感的临床护理和自我护理资源。该计划还将促进骨盆底疾病多学科学员的职业发展，并作为未来预防骨盆底疾病研究合作的资源。为了实现这一目标，该计划结构包括3个核心，行政（A），生物统计学（B）和临床协调（C），这反过来又将支持3个项目：项目1：腹内压和产后骨盆底支持和症状;项目2：体力活动，不活动和健身：对产后骨盆底支持和症状的影响;项目3：阴道分娩后产后骨盆底支持的文化背景：墨西哥裔美国人和欧美女性的比较民族志分析。该计划创建了一个由致力于研究的研究人员组成的协同团队，并将他们的技能，想法和资源编织成一个最佳环境，以便发现将改善妇女健康的发现。

 DESCRIPTION (provided by applicant): The Program Project, "Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery" uses mixed methods research to study the influence of intra-abdominal pressure, physical activity and strength on pelvic floor support and symptoms and the cultural context in which women experience those changes. Up to 1 in 7 women undergoes surgery for pelvic organ prolapse or urinary incontinence in her lifetime. Despite the high prevalence and high cost of treating these disorders, urgently needed prevention strategies are scare, reflecting the current state of knowledge. Supported by an exceptional institutional environment and a robust research infrastructure, this Program Project is uniquely positioned to address its primary hypothesis that understanding factors associated with pelvic floor support and symptoms after the first vaginal delivery will lead to developing and testing novel prevention strategies. In this mixed methods research, the core group of 11 investigators from 4 University of Utah colleges will build on the rich tradition of excellence at the University of Utah in research involving pregnant or postpartum women, bioengineering, exercise science, qualitative research, and pelvic floor disorders, to tackle together problems that continue to plague research in pelvic floor disorders. The scope of this project is relevant to the portfolio of the Gynecologic Health and Disease Branch within NICHD, which specifically includes pelvic floor disorders. The aim of this Program is to lay the groundwork for humanistic evidence-based interventions that mitigate the impact of vaginal delivery on deteriorations in pelvic floor support and symptoms with an eye toward early detection, prevention of future bothersome pelvic floor disorders, and provision of culturally sensitive clinical care and self-care resources. The Program will also promote career development of multi-disciplinary trainees in pelvic floor disorders and serve as a resource for future research collaboration in the prevention of pelvic floor disorders. To accomplish this aim, the Program structure includes 3 Cores, Administrative (A), Biostatistics (B) and Clinical Coordination (C), which in turn will support 3 Projects: Project 1: Intra-abdominal pressure and postpartum pelvic floor support and symptoms; Project 2: Physical activity, inactivity, and fitness: Impact on postpartum pelvic floor support and symptoms; and Project 3: The cultural context of postpartum pelvic floor support following vaginal delivery: a comparative ethnographic analysis of Mexican-American and Euro-American women. The Program creates a synergistic team of committed researchers and weaves their skills, ideas, and resources into an optimal environment in which to make discoveries that will improve the health of women.