Life-course pathways linking adolescent childbearing to chronic conditions: A pilot study to reinforce research and health system capacity in Northeast Brazil

项目概述：该项目有两个主要目标：1)改善卫生系统和研究能力 在圣克鲁斯社区，它位于巴西东北部地区，2)将这一能力应用于 为了进行流行病学研究，调查可能解释青少年如何以及为什么 在中老年妇女中，分娩与慢性病和行动不便有关。是这样的 信息对于制定预防公共卫生干预措施以应对非传染性疾病至关重要 整个生命过程中的疾病。从这项研究中吸取的经验教训将增加研究的证据基础 关于拉丁美洲少女怀孕以及更广泛的妇女健康问题的政策和行动。 具体地说，该项目旨在：1)培训里约联邦大学圣克鲁斯校区的学生 Grande do Norte(巴西)进行流行病学访谈，收集生物样本，并采取 人体测量和临床测量。它还将提供深入的、专门的伦理研究培训 在与孕妇和青少年妇女一起工作时进行指导；2)制定和验证流行病学 适用于低教育、农村、青少年、讲葡萄牙语人口的调查问卷；3) 从1日开始，前瞻性地跟踪调查第一次怀孕的青少年和成年女性的试点队列 怀孕三个月至产后6周。该试点项目将收集问卷数据(基线)、临床数据 测量和生物标记物浓度(基线、妊娠晚期、产后6周)。建议数 先导性研究是第三个研究目标，将为更广泛和更全面的研究奠定基础 研究项目，调查先前记录的关联背后的假设机制 青春期分娩和晚年健康状况不佳之间的矛盾。总体而言，由此建立和维持的能力 该项目将有助于在巴西服务最匮乏的地区之一推进卫生研究。会的 为下一代巴西研究人员提供培训，并在两国之间建立长期网络 巴西和美国的研究人员。

Project Summary: This project has two principal objectives: 1) Improve health system and research capacity in the community of Santa Cruz, which is located in the region of Northeast Brazil and 2) Apply that capacity in order to conduct epidemiological research investigating pathways that may explain how and why adolescent childbirth is associated to chronic conditions and mobility loss in middle-aged and older women. Such information is vital to developing preventative public health interventions to address non-communicable diseases across the life-course. Lessons learned from this research would add to the research evidence-base for policy and action on adolescent pregnancy and, more broadly, women's health in Latin America. Specifically, this project aims to: 1) Train students from the Santa Cruz campus of the Federal University of Rio Grande do Norte (Brazil) to conduct epidemiological interviews, collect biological samples, and take anthropometric and clinical measures. It will also provide in-depth, specialized training on ethical research conduct when working with pregnant and adolescent women; 2) Develop and validate epidemiological questionnaires adapted to a low-education, rural, adolescent, Portuguese-speaking population; 3) Prospectively follow a pilot cohort of adolescent and adult women, pregnant for the first time, from the 1st trimester of pregnancy to 6-weeks postpartum. This pilot would collect questionnaire data (baseline), clinical measurements, and biomarker concentrations (baseline, 3rd trimester, 6-weeks postpartum). The proposed pilot study, which is the 3rd study aim, will lay the foundation for a more expansive and comprehensive research program investigating hypothesized mechanisms behind previously documented associations between adolescent childbirth and poor later-life health. Overall, the capacity built and sustained from this project will contribute to advancing health research in one of the most underserved regions of Brazil. It will provide training to the next generation of Brazilian researchers and establish long-term networks between Brazilian and United States researchers.