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.

项目概要/摘要 这是 Lauren Theilen 博士的 K23 提案，她是一位具有长期专业知识的母胎医学医师 妊娠期高血压疾病后的孕产妇健康 为了研究改善策略。 复杂妊娠后女性的心血管 (CV) 健康，这款 K23 将使 Theilen 博士能够 获得四个职业发展领域的关键技能：1）定性和混合方法研究方法； 2) 开发和完善患者决策辅助工具；3) 设计和进行临床试验；4) 为了实现她的目标，Theilen 博士组建了一个研究领导力和管理技能的团队。 跨学科指导团队由高级研究员 Michael Varner 博士（主要导师）和 围产期临床试验领域公认的领导者，以及三位共同导师：鲍勃·西尔弗 (Bob Silver) 博士，一位卓有成就的研究员 在怀孕领域作为未来健康的窗口，Susan Zickmund 博士是一位定性和混合专家 方法研究，以及患者风险沟通和决策领域的领先研究者 Elissa Ozanne 博士 Theilen 博士还设有一个由 3 名成员组成的顾问委员会，以补充该指导团队的发展。 支持她提出的决策援助开发和试点试验目前的证据表明，女性。 妊娠期高血压疾病日后发生心血管疾病 (CVD) 的风险高出 2 倍 与健康怀孕的女性相比，预防心血管疾病对于女性健康来说是重中之重，因为它是最重要的。 美国女性的首要死因 为了改善女性的心血管健康， 妊娠并发高血压后不久即可开始预防心血管疾病的干预措施 然而，很少有研究人员接受过开发以患者为中心的干预措施来促进疾病的培训。 Theilen 博士的目标是解决产后妇女预防保健方面目前的差距。 产后妇女 CVD 预防的需求、价值观和障碍的知识 妊娠期高血压疾病，并弥补缺乏可用的循证干预措施 她提出了以下具体目标： 目标 1) 确定信息需求、价值观、 影响产后妇女及其产科的心血管风险沟通和参与的障碍 目标 2) 开发决策辅助工具以提高患者心血管风险知识和 患有妊娠期高血压疾病的产后妇女的预防性健康参与；以及目标 3) 进行一项试点研究，以证明患者决策辅助的有效性和初步功效，以改善 患者关于产后CVD预防的知识和自我效能。 研究意义重大，因为它调查了一种减少患有心血管疾病的女性心血管疾病负担的策略 该提议具有创新性，因为它包含了实质性的偏离。 来自美国现有的产后临床护理范例。

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。

• 发表时间: 2024-04-03
• 作者: Theilen, Lauren H;Varner, Michael W;Esplin, M Sean;Horne, Benjamin D
• 通讯作者: Horne, Benjamin D

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。

• 发表时间: 2023-04
• 作者: Bruno, Ann M;Allshouse, Amanda A;Metz, Torri D;Theilen, Lauren H
• 通讯作者: Theilen, Lauren H