Optimizing Cardiovascular Preventive Care for Women following Hypertensive Disorders of Pregnancy.

优化妊娠期高血压疾病女性的心血管预防护理。

• 批准号: 10631132
• 负责人: Lauren Theilen
• 金额: $ 17.71万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10631132
• 关键词: Address; Advisory Committees; Affect; Age; American Heart Association; Area; Attitude; Cardiovascular Diseases; Cardiovascular system; Caring; Cause of Death; Cessation of life; Client satisfaction; Clinical; Clinical Trials; Communication; Complement; Conduct Clinical Trials; Data; Decision Aid; Decision Making; Development; Discipline of obstetrics; Event; Evidence based intervention; Future; Goals; Health; Heart Diseases; Hypertension; Incidence; Intervention; Interview; K-Series Research Career Programs; Knowledge; Leadership; Learning; Life; Longevity; Maternal Health; Maternal-fetal medicine; Mentors; Outcome; Patient Education; Patient risk; Patient-Focused Outcomes; Patients; Perinatal; Persons; Physicians; Pilot Projects; Populations at Risk; Positioning Attribute; Postpartum Period; Postpartum Women; Pregnancy; Pregnancy Complications; Prevention; Preventive; Preventive care; Process; Provider; Recommendation; Research; Research Methodology; Research Personnel; Risk; Self Care; Self Efficacy; Silver; Specialist; Stroke; Structure; Symptoms; Testing; Training; United States; Woman; Women' s Health; Work; burden of illness; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; career development; clinical care; communication aid; design; disability; efficacy testing; evidence base; healthy pregnancy; high risk; improved; innovation; lifetime risk; member; men; obstetric care; patient engagement; patient oriented; pilot trial; pregnancy disorder; prevent; primary care provider; programs; prototype; reproductive; skills; standard care; therapy design; tool; trial comparing; trial design

PROJECT SUMMARY/ABSTRACT This is a K23 proposal for Dr. Lauren Theilen, a Maternal-Fetal Medicine physician with expertise in long-term maternal health following hypertensive disorders of pregnancy. In order to investigate strategies for improved cardiovascular (CV) health among women following complicated pregnancy, this K23 will allow Dr. Theilen to acquire critical skills in four career development areas: 1) qualitative and mixed methods research approaches; 2) development and refinement of a patient decision aid; 3) design and conduct of clinical trials; and 4) research leadership and management skills. To achieve her goals, Dr. Theilen has assembled an interdisciplinary mentoring team comprised of Dr. Michael Varner (Primary Mentor), a senior investigator and recognized leader in perinatal clinical trials, and three Co-Mentors: Dr. Bob Silver, an accomplished researcher in the field of pregnancy as a window to future health, Dr. Susan Zickmund, an expert in qualitative and mixed methods research, and Dr. Elissa Ozanne, a leading investigator in patient risk communication and decision aid development. Complementing this mentoring team, Dr. Theilen also has a 3-member advisory committee to support her proposed decision aid development and pilot trial. Current evidence demonstrates that women with hypertensive disorders of pregnancy have 2-fold higher risk for the later development of CV disease (CVD) compared to women with healthy pregnancies. CVD prevention is a high priority for women’s health, as it is the leading cause of death among women in the United States. In order to improve women’s CV health, interventions for CV prevention could be initiated shortly after a pregnancy complicated by a hypertensive disorder. However, few researchers are trained in developing patient-centered interventions to promote preventive care engagement among postpartum women. Dr. Theilen’s objective is to address current gaps in knowledge regarding needs, values, and barriers regarding CVD prevention among postpartum women with hypertensive disorders of pregnancy, and to remedy the lack of available evidence-based interventions for this at-risk population. She proposes the following Specific Aims: Aim 1) Determine information needs, values, and barriers influencing CV risk communication and engagement among postpartum women and their obstetric and primary care providers; Aim 2) Develop a decision aid to improve patient CV risk knowledge and preventive health engagement for postpartum women with hypertensive disorders of pregnancy; and Aim 3) Conduct a pilot study to demonstrate feasibility and preliminary efficacy of a patient decision aid to improve patient knowledge and self-efficacy regarding CVD prevention during the postpartum period. The proposed research is significant because it investigates a strategy to reduce the CVD burden among women with hypertensive disorders of pregnancy. This proposal is innovative because it comprises a substantial departure from the existing postpartum clinical care paradigm in the United States.

项目摘要/摘要 这是对劳伦·泰伦（Lauren Theilen）博士的K23提案，他是一位具有长期专业知识的母亲医学医学 高血压疾病怀孕后的孕产妇健康。为了调查改进的策略 复杂怀孕后，女性的心血管（CV）健康，该K23将使Theilen博士得以实现 在四个职业发展领域获得关键技能：1）定性和混合方法研究方法； 2）患者决策援助的发展和完善； 3）设计和进行临床试验；和4） 研究领导和管理技能。为了实现她的目标，泰伦博士已经组装了 跨学科指导团队完成了高级调查员迈克尔·瓦尔纳（Michael Varner）博士（主要导师）和 围产期临床试验的公认领导者和三位联合官员：鲍勃·西尔弗（Bob Silver）博士，有成就的研究员 在怀孕领域，作为未来健康的窗口，苏珊·齐克蒙德博士是定性和混合的专家 方法研究和患者风险交流和决策领域的主要研究者Elissa Ozanne博士 援助发展。与这个心理团队相辅相成，Thilen博士还拥有一个由三人组成的咨询委员会 支持她提议的决策援助开发和试点审判。当前的证据表明，有 怀孕的高血压疾病患CV疾病（CVD）的风险高2倍 与健康怀孕的妇女相比。预防CVD是女性健康的重中之重，因为这是 美国妇女中的主要死亡原因。为了改善妇女的简历健康， 预防简历的干预措施可在怀孕后不久因高血压复杂而开始 紊乱。但是，很少有研究人员受过培训以开发以患者为中心的干预措施来促进 产后妇女的预防护理参与。 Theilen博士的目标是解决当前差距 有关产后妇女中有关CVD预防CVD预防的需求，价值和障碍的知识 怀孕的高血压疾病，并记住缺乏可用的基于证据的干预措施 高危人口。她提出以下具体目的：目标1）确定信息需求，价值， 障碍会影响产后妇女及其产科的简历风险沟通和参与 和初级保健提供者；目标2）制定决策援助，以改善患者简历风险知识和 对产后妊娠高血压疾病的预防健康参与；和目标3） 进行试点研究，以证明患者决策援助的可行性和初步效率 在产后期间，有关CVD预防的患者知识和自我效能。提议 研究之所以重要，是因为它调查了一种减少患有CVD燃烧的策略 怀孕的高血压疾病。该提议具有创新性 来自美国现有的产后临床护理范式。

项目成果

Cardiovascular morbidity and mortality following hypertensive disorders of pregnancy.

妊娠期高血压疾病后的心血管发病率和死亡率。

• DOI: 10.1016/j.preghy.2024.101122
• 发表时间: 2024
• 期刊: Pregnancy hypertension
• 作者: Theilen,LaurenH;Varner,MichaelW;Esplin,MSean;Horne,BenjaminD
• 通讯作者: Horne,BenjaminD

Hypertensive disorders of pregnancy pre- and postaspirin guideline publication in individuals with pregestational diabetes mellitus.

妊娠前糖尿病患者服用阿司匹林前后的妊娠高血压疾病指南出版。

• DOI: 10.1016/j.ajogmf.2023.100877
• 发表时间: 2023
• 期刊: American journal of obstetrics & gynecology MFM
• 影响因子: 6.3
• 作者: Bruno,AnnM;Allshouse,AmandaA;Metz,TorriD;Theilen,LaurenH
• 通讯作者: Theilen,LaurenH