My long-term career goal is to substantially improve women's health in the field of urogynecology by becoming a well-trained, independent clinician-scientist who is able to use innovative tools to identify the root causes of pelvic floor disorders and translate those findings into improved clinical practice. To achieve this goal, I have obtained the essential clinical and surgical training in urogynecology to fully comprehend the challenges in prevention, management and treatment of pelvic floor disorders. I have also developed a robust foundation in clinical research and modeling through my MPH in epidemiology and prior research endeavors. Through these collective experiences, I ultimately realized that advances in translational research, focused on the pathophysiology of pelvic floor disorders, are needed to revolutionize women's health in urogynecology. Thus, I am applying for this K23 Mentored Patient-Oriented Research Career Development Award in order to obtain advanced training and mentorship in human genetics and genetic epidemiology. Topic: Female pelvic floor disorders (PFD) represent a major public health burden given their high prevalence, impairment of quality of life, and substantial economic costs. The underlying pathophysiology of these disorders is not well understood, and without this critical knowledge, effective preventive strategies and long-term treatments have not been developed. Identification of the fundamental causes of PFDs will be achieved through innovative translational research. Plan: My multidisciplinary educational plan entails acquiring additional skills in genetic epidemiology through intensive coursework, dedicated mentoring and productive research. My research will focus on identifying genetic risk factors for pelvic organ prolapse through a candidate gene association study (Aim 1). Through this research, I will gain crucial """"""""hands-on"""""""" experience and knowledge, strengthen collaborations within and across institutions, and establish the groundwork for future, large-scale investigations. With advances in our understanding of the genetic susceptibility for prolapse, it is critical to simultaneously explore how we will eventually integrate these genetic findings into clinical practice. Thus, I will also estimate the potential clinical and economic impact of a genetic susceptibility test for prolapse using a computer simulation model (Aim 2). This novel proposal will foster valuable collaboration between clinical scientists and geneticists and advance the implementation of translational medicine into the evolving field of urogynecology in order to ultimately improve women's health.

Public Health Relevance

Female pelvic floor disorders represent a major public health burden given their high prevalence, impairment of quality of life, and substantial economic costs. Identifying the fundamental causes of pelvic floor disorders and translating these findings into improved preventive and treatment strategies will significantly impact women's health.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD068404-02
Application #
8261921
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Meikle, Susan
Project Start
2011-05-15
Project End
2013-02-28
Budget Start
2012-05-01
Budget End
2013-02-28
Support Year
2
Fiscal Year
2012
Total Cost
$127,303
Indirect Cost
$9,430
Name
Duke University
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Kinlaw, Alan C; Jonsson Funk, Michele; Conover, Mitchell M et al. (2018) Impact of New Medications and $4 Generic Programs on Overactive Bladder Treatment Among Older Adults in the United States, 2000-2015. Med Care 56:162-170
Kinlaw, Alan C; Jonsson Funk, Michele; Steiner, Michael J et al. (2017) Trends in Pharmacotherapy for Bladder Dysfunction Among Children in the United States, 2000 to 2013. Clin Pediatr (Phila) 56:55-64
Dieter, Alexis A; Wilkins, Maggie F; Wu, Jennifer M (2015) Epidemiological trends and future care needs for pelvic floor disorders. Curr Opin Obstet Gynecol 27:380-4
Conover, Mitchell M; Jonsson Funk, Michele; Kinlaw, Alan C et al. (2015) Trends and Patterns of Urodynamic Studies in U.S. Males, 2000-2012. PLoS One 10:e0133657
Conover, Mitchell M; Howell, Jennifer O; Wu, Jennifer M et al. (2015) Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012. Pharmacoepidemiol Drug Saf 24:875-84
Wu, Jennifer M; Matthews, Catherine A; Vaughan, Camille P et al. (2015) Urinary, fecal, and dual incontinence in older U.S. Adults. J Am Geriatr Soc 63:947-53
Conover, Mitchell M; Jonsson Funk, Michele; Kinlaw, Alan C et al. (2015) Trends and patterns of urodynamic studies in U.S. women, 2000-2012. Obstet Gynecol 125:559-65
Giri, Ayush; Wu, Jennifer M; Ward, Renee M et al. (2015) Genetic Determinants of Pelvic Organ Prolapse among African American and Hispanic Women in the Women's Health Initiative. PLoS One 10:e0141647
Wu, Jennifer M; Matthews, Catherine A; Conover, Mitchell M et al. (2014) Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol 123:1201-6
Wu, Jennifer M; Vaughan, Camille P; Goode, Patricia S et al. (2014) Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol 123:141-8

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