Reducing Cardiovascular Risk in Women with Hypertension or Diabetes in Pregnancy

Summary

Principal Investigator: WENDY LYNET BENNETT
Abstract: 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.
Funding Period: 2010-08-20 - 2015-06-30
more information: NIH RePORT

Top Publications

  1. ncbi A brief two-item screener for detecting a history of physical or sexual abuse in childhood
    Brett D Thombs
    Department of Psychiatry, Sir Mortimer B Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada H3T 1E4
    Gen Hosp Psychiatry 29:8-13. 2007
  2. pmc Utilization of primary and obstetric care after medically complicated pregnancies: an analysis of medical claims data
    Wendy L Bennett
    Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E Monument St, Suite 2 616, Baltimore, MD, 21205, USA
    J Gen Intern Med 29:636-45. 2014
  3. pmc Prepregnancy body mass index and cardiovascular disease mortality: the Child Health and Development Studies
    Morgana L Mongraw-Chaffin
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    Obesity (Silver Spring) 22:1149-56. 2014
  4. pmc Insights from the POWER practice-based weight loss trial: a focus group study on the PCP's role in weight management
    Wendy L Bennett
    Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA
    J Gen Intern Med 29:50-8. 2014
  5. pmc Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: the CARDIA study
    Wendy L Bennett
    Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    Obesity (Silver Spring) 21:1269-75. 2013
  6. pmc Transforming the healthcare response to intimate partner violence and taking best practices to scale
    Michele R Decker
    Johns Hopkins Bloomberg School of Public Health, Department of Population Family and Reproductive Health Women s and Children s Health Policy Center, Baltimore, Maryland 21205, USA
    J Womens Health (Larchmt) 21:1222-9. 2012
  7. ncbi Development and pilot test of a process to identify research needs from a systematic review
    Ian J Saldanha
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
    J Clin Epidemiol 66:538-45. 2013
  8. pmc Primary care providers' communication with patients during weight counseling: a focus group study
    Kimberly A Gudzune
    Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
    Patient Educ Couns 89:152-7. 2012
  9. pmc High priority research needs for gestational diabetes mellitus
    Wendy L Bennett
    Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 2024 E Monument Street, Baltimore, MD 21205, USA
    J Womens Health (Larchmt) 21:925-32. 2012
  10. pmc Impact of physician BMI on obesity care and beliefs
    Sara N Bleich
    Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    Obesity (Silver Spring) 20:999-1005. 2012

Detail Information

Publications15

  1. ncbi A brief two-item screener for detecting a history of physical or sexual abuse in childhood
    Brett D Thombs
    Department of Psychiatry, Sir Mortimer B Davis Jewish General Hospital and McGill University, Montreal, Quebec, Canada H3T 1E4
    Gen Hosp Psychiatry 29:8-13. 2007
    ..The objective of this study was to assess the accuracy of a two-item screener for physical or sexual abuse in childhood...
  2. pmc Utilization of primary and obstetric care after medically complicated pregnancies: an analysis of medical claims data
    Wendy L Bennett
    Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E Monument St, Suite 2 616, Baltimore, MD, 21205, USA
    J Gen Intern Med 29:636-45. 2014
    ..Because pregnancy complications, including gestational diabetes mellitus (GDM) and hypertensive disorders in pregnancy, are risk factors for diabetes and cardiovascular disease, post-delivery follow-up is recommended...
  3. pmc Prepregnancy body mass index and cardiovascular disease mortality: the Child Health and Development Studies
    Morgana L Mongraw-Chaffin
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    Obesity (Silver Spring) 22:1149-56. 2014
    ....
  4. pmc Insights from the POWER practice-based weight loss trial: a focus group study on the PCP's role in weight management
    Wendy L Bennett
    Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA
    J Gen Intern Med 29:50-8. 2014
    ..This trial provided a unique opportunity to understand PCPs' actual and desired roles in a multi-component weight loss intervention...
  5. pmc Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: the CARDIA study
    Wendy L Bennett
    Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    Obesity (Silver Spring) 21:1269-75. 2013
    ..Prepregnancy to postpregnancy change in weight, body mass index (BMI), waist circumference, diet, and physical activity in women with and without gestational diabetes mellitus (GDM) were compared...
  6. pmc Transforming the healthcare response to intimate partner violence and taking best practices to scale
    Michele R Decker
    Johns Hopkins Bloomberg School of Public Health, Department of Population Family and Reproductive Health Women s and Children s Health Policy Center, Baltimore, Maryland 21205, USA
    J Womens Health (Larchmt) 21:1222-9. 2012
    ..These policy developments require that effective clinic-based interventions be identified, easily implemented, and taken to scale...
  7. ncbi Development and pilot test of a process to identify research needs from a systematic review
    Ian J Saldanha
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
    J Clin Epidemiol 66:538-45. 2013
    ..We developed and pilot tested a process to identify needs for primary clinical research using a systematic review in gestational diabetes mellitus...
  8. pmc Primary care providers' communication with patients during weight counseling: a focus group study
    Kimberly A Gudzune
    Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
    Patient Educ Couns 89:152-7. 2012
    ..Primary care providers (PCPs) are encouraged to counsel their obese patients about weight loss. We used focus groups to explore how PCPs communicate with patients about weight management...
  9. pmc High priority research needs for gestational diabetes mellitus
    Wendy L Bennett
    Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 2024 E Monument Street, Baltimore, MD 21205, USA
    J Womens Health (Larchmt) 21:925-32. 2012
    ..We developed a process for elucidating the highest priority research questions on GDM...
  10. pmc Impact of physician BMI on obesity care and beliefs
    Sara N Bleich
    Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
    Obesity (Silver Spring) 20:999-1005. 2012
    ..These results suggest that more normal weight physicians provided recommended obesity care to their patients and felt confident doing so...
  11. pmc Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations
    Wendy L Bennett
    The Johns Hopkins University School of Medicine and The Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21205, USA
    Ann Intern Med 154:602-13. 2011
    ..Given the increase in medications for type 2 diabetes mellitus, clinicians and patients need information about their effectiveness and safety to make informed choices...
  12. pmc Barriers to and facilitators of postpartum follow-up care in women with recent gestational diabetes mellitus: a qualitative study
    Wendy L Bennett
    Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
    J Womens Health (Larchmt) 20:239-45. 2011
    ..We explored barriers to and facilitators of postpartum follow-up care in women with recent GDM...
  13. pmc Perceived judgment about weight can negatively influence weight loss: a cross-sectional study of overweight and obese patients
    Kimberly A Gudzune
    Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA Electronic address
    Prev Med 62:103-7. 2014
    ..To examine the association between patient-perceived judgments about weight by primary care providers (PCPs) and self-reported weight loss...

Research Grants30

  1. Boston Puerto Rican Health Study - CVD Risk Factors
    Katherine L Tucker; Fiscal Year: 2013
    ..abstract_text> ..
  2. COBRE Center for Central Nervous System Function
    Jerome N Sanes; Fiscal Year: 2013
    ..The COBRE Center will leverage the administrative resources available through the Brown Institute for Brain Science to ensure efficient operation and coordinate with other brain science research activities at Brown. ..
  3. Metabolic Effects of In Utero Antiretrovirals on HIV Exposed Uninfected Infants
    Jennifer Jao; Fiscal Year: 2013
    ..Moreover, future studies would be crucial in distinguishing which ARVs may or may not represent a safer regimen for both the HIV- infected woman and her offspring. ..
  4. Hopkins Center for Eliminate Cardiovascular Health Disparities
    Lisa A Cooper; Fiscal Year: 2013
    ..abstract_text> ..
  5. Rush Center for Urban Health Equity
    Lynda H Powell; Fiscal Year: 2013
    ..Funding is now sought to bring these resources together to establish a unique center of excellence in health disparities interventions. ..
  6. STUDIES OF JOINT AGING AND OSTEOARTHRITIS
    Martin K Lotz; Fiscal Year: 2013
    ..Sah) will analyze biomechanical mechanisms of early and advanced cartilage degeneration and determine consequences for chondrocyte function and survival. ..
  7. Task Shifting and Blood Pressure Control in Ghana: A Cluster- Randomized Trial.
    GBENGA GODWIN OGEDEGBE; Fiscal Year: 2013
    ....
  8. Notch-Mediated Expansion of Cord Blood Progenitors for Stem Cell Transplant
    Colleen Delaney; Fiscal Year: 2013
    ..Our goal is to now determine the clinical efficacy of this approach in a phase II clinical trial. ..
  9. Family and Neighborhood Interventions to Reduce Heart Disease Risk in East L.A.
    Alexander N Ortega; Fiscal Year: 2013
    ....
  10. Center of Excellence for Health Disparties in the Nation's Capital
    PHYLLIS R MAGRAB; Fiscal Year: 2013
    ..The important cross-cutting objectives of Cultural Competence intersect with each of these areas. ..