Reducing Cardiovascular Risk in Women with Hypertension or Diabetes in Pregnancy

降低妊娠期高血压或糖尿病女性的心血管风险

• 批准号: 8700465
• 负责人: Wendy Lynet Bennett
• 金额: $ 13.92万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-20 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700465
• 关键词: Address; Affect; Behavior; Behavior Therapy; Behavioral; Blood Vessels; Cardiovascular Diseases; Caring; Cause of Death; Chronic Disease; Clinical Research; Clinical Trials Design; Cohort Studies; Conduct Clinical Trials; Data; Data Analyses; Development; Development Plans; Diagnosis; Discipline of obstetrics; Disease; Effectiveness of Interventions; Enabling Factors; Epidemiology; Fellowship; Future; Gestational Diabetes; Glucose Intolerance; Goals; Grant; Health Insurance; Health Surveys; Health behavior; Health behavior change; Healthcare; Heart Diseases; High Prevalence; High Risk Woman; Hypertension; Inflammatory; Insurance; Internal Medicine; Intervention; Intervention Studies; Lead; Life; Life Style; Long-Term Effects; Medical; Medical Surveillance; Medicine; Mentors; Metabolic; Metabolic syndrome; Minority Groups; Modeling; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Pattern; Physiological; Population; Postpartum Period; Predisposing Factor; Predisposition; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Preventive; Primary Health Care; Primary Prevention; Principal Investigator; Recommendation; Recruitment Activity; Reinforcing Factor; Research; Research Personnel; Resources; Risk; Risk Factors; Sampling; Science; Stress Tests; Training; United States; Universities; Visit; Woman; abstracting; cardiovascular disorder risk; cardiovascular risk factor; career; career development; clinical research site; design; effective intervention; experience; follow-up; health care service utilization; heart disease risk; high risk; improved; medical schools; men; mortality; professor; programs; prospective; skills

DESCRIPTION (provided by applicant): Women with recent pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders in pregnancy (HDP), have an increased risk of developing cardiovascular disease (CVD). Pregnancy provides a unique opportunity to identify women with these vascular risk factors earlier in life. Yet, we are missing this window of opportunity, as women are often lost to follow- up postpartum and do not received recommended care. There is a paucity of evidence on how to effectively promote and sustain CVD-preventive health behaviors in this high risk population. The overall objective of the proposed study is to identify barriers to and predictors of CVD-preventive health behaviors, including medical follow-up and healthy lifestyle behaviors, in the postpartum period in women with recent GDM and HDP. Using the PRECEDE-PROCEED model, we will use these findings to develop an interventional study to address the predisposing, enabling and reinforcing factors that influence CVD-preventive health behaviors. Results from this proposal could have broad implications for the development of practical and sustainable strategies to decrease CVD morbidity and mortality in women. The specific aims are to: 1) conduct a retrospective cohort study to describe healthcare utilization patterns and predictors of follow-up medical care in the first year postpartum in women with GDM and/or HDP; 2) conduct a prospective cohort study to determine predictors CVD-preventive behaviors in the first year postpartum in women with GDM and/or HDP; 3) design and carry-out a pilot multilevel educational-behavioral intervention to increase CVD-preventive health behaviors in women with GDM and/or HDP. The candidate is completing a clinical research fellowship in General Internal Medicine (GIM) at Johns Hopkins University School of Medicine and will take an Assistant Professor post at Johns Hopkins in July, 2009. Her primary mentor is Dr. Jeanne Clark, Associate Professor of Medicine and Epidemiology, with extensive experience in mentoring, epidemiology, and the design of clinical trials. Her co-mentor is Dr. David Levine, Professor of Medicine, principal investigator of the NHLBI training grant on behavioral aspects of CVD and an established investigator and mentor. The candidate's long term career goal is to establish an independent research program in the primary prevention of CVD in women. To accomplish this goal, her short term goals involve a career development plan to enhance her skills in longitudinal data analysis, health survey research, health behavior science, and the design and conduct of clinical trials. Results of this proposal will lead to the development of a pilot intervention in years 4 and 5 and an R01 proposal early in year 5 to investigate the effectiveness of an intervention to improve CVD-preventive health behaviors in the postpartum period in women with recent GDM and/or HDP.

描述（由申请人提供）：近期患有妊娠并发症（例如妊娠糖尿病（GDM）和妊娠期高血压疾病（HDP））的女性患心血管疾病（CVD）的风险增加。怀孕提供了一个独特的机会来识别女性在生命早期是否患有这些血管危险因素。然而，我们错过了这个机会之窗，因为女性常​​常无法进行产后随访，也没有得到推荐的护理。关于如何在这一高危人群中有效促进和维持心血管疾病预防健康行为的证据很少。拟议研究的总体目标是确定近期患有 GDM 和 HDP 的女性产后 CVD 预防健康行为的障碍和预测因素，包括医疗随访和健康的生活方式行为。通过 PRECEDE-PROCEED 模型，我们将利用这些发现开展一项干预研究，以解决影响 CVD 预防健康行为的诱发因素、促成因素和强化因素。该提案的结果可能对制定实用且可持续的战略以降低女性心血管疾病发病率和死亡率产生广泛影响。具体目标是：1) 进行一项回顾性队列研究，描述 GDM 和/或 HDP 女性产后第一年的医疗保健利用模式和后续医疗护理的预测因素； 2) 进行一项前瞻性队列研究，以确定 GDM 和/或 HDP 女性产后第一年 CVD 预防行为的预测因子； 3) 设计并实施试点多层次教育行为干预措施，以增强 GDM 和/或 HDP 女性的 CVD 预防健康行为。该候选人即将完成约翰霍普金斯大学医学院普通内科 (GIM) 的临床研究奖学金，并将于 2009 年 7 月在约翰霍普金斯大学担任助理教授职位。她的主要导师是医学副教授 Jeanne Clark 博士流行病学，在指导、流行病学和临床试验设计方面拥有丰富的经验。她的共同导师是 David Levine 博士，他是医学教授、NHLBI CVD 行为方面培训资助的首席研究员，也是一位知名的研究者和导师。候选人的长期职业目标是建立女性心血管疾病一级预防的独立研究计划。为了实现这一目标，她的短期目标包括职业发展计划，以提高她在纵向数据分析、健康调查研究、健康行为科学以及临床试验的设计和实施方面的技能。该提案的结果将导致在第 4 年和第 5 年制定一项试点干预措施，并在第 5 年年初制定一项 R01 提案，以调查干预措施的有效性，以改善近期患有 GDM 和 GDM 的女性产后 CVD 预防健康行为。 /或HDP。

项目成果

Provider Counseling About and Risk Perception for Future Chronic Disease Among Women with Gestational Diabetes and Preeclampsia.

• DOI: 10.1089/jwh.2019.7767
• 发表时间: 2020-05
• 期刊: Journal of women's health
• 作者: Lauren Sutherland;D. Neale;J. Henderson;J. Clark;D. Levine;W. Bennett

Obesity-Related Dietary Behaviors among Racially and Ethnically Diverse Pregnant and Postpartum Women.

• DOI: 10.1155/2016/9832167
• 发表时间: 2016
• 期刊: Journal of pregnancy
• 影响因子: 3.2
• 作者: Harris A;Chilukuri N;West M;Henderson J;Lawson S;Polk S;Levine D;Bennett WL
• 通讯作者: Bennett WL

A brief two-item screener for detecting a history of physical or sexual abuse in childhood.

一项简短的两项筛查，用于检测儿童时期的身体虐待或性虐待史。

• DOI: 10.1016/j.genhosppsych.2006.10.013
• 发表时间: 2007
• 期刊: General hospital psychiatry
• 影响因子: 7
• 作者: Thombs,BrettD;Bernstein,DavidP;Ziegelstein,RoyC;Bennett,Wendy;Walker,EdwardA
• 通讯作者: Walker,EdwardA

Information and Communication Technology Use Among Low-Income Pregnant and Postpartum Women by Race and Ethnicity: A Cross-Sectional Study.

• DOI: 10.2196/jmir.3916
• 发表时间: 2015-07-03
• 期刊: Journal of medical Internet research
• 影响因子: 7.4
• 作者: Chilukuri N;West M;Henderson JL;Lawson S;Ehsanipoor R;Costigan K;Polk S;Bennett W
• 通讯作者: Bennett W

Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations.

• DOI: 10.7326/0003-4819-154-9-201105030-00336
• 发表时间: 2011-05-03
• 期刊: Annals of internal medicine
• 影响因子: 39.2
• 作者: Bennett WL;Maruthur NM;Singh S;Segal JB;Wilson LM;Chatterjee R;Marinopoulos SS;Puhan MA;Ranasinghe P;Block L;Nicholson WK;Hutfless S;Bass EB;Bolen S
• 通讯作者: Bolen S