Tammy Chang, MD, MPH, MS is a family physician and junior clinical investigator focused on reducing obesity among adolescent mothers and their children. Dr. Chang's long-term career objective is to reduce health disparities among low-income adolescent mothers using tailored eHealth technologies. The objective of this K23 mentored career development award includes a 5-year plan for training and research activities that will provide the skills and experiences needed to become a successful independent investigator. RESEARCH CONTEXT: The United States (US) has one of the highest adolescent pregnancy rates in the developed world; the majority of pregnant adolescents gain excess weight during pregnancy. Excess pregnancy weight gain has a significant negative impact on the health of the adolescent mother, increases the risk of dangerous complications during delivery, and contributes to long-term obesity for both mother and child. In recognition of this important population health problem, both the IOM and AHRQ have identified the development of interventions targeting excess pregnancy weight gain as a major research priority. Compared to adults, relatively little is known about pregnancy weight gain among adolescents. Therefore, there is a critical need to understand adolescents' perceptions of and knowledge about pregnancy weight gain, so that researchers can customize interventions and make them relevant to the pregnant adolescent. The short-term goal of this proposal is to acquire the requisite skills to develop an adolescent-centered tailored eHealth intervention to reduce excess pregnancy weight gain.
SPECIFIC AIMS : 1) Determine which US pregnant adolescents (aged ?21 years) are at high risk for significant excess pregnancy weight gain; 2) Identify the baselin knowledge, beliefs, and factors that influence excess pregnancy weight gain among adolescents; and 3) Design and test a scalable healthy diet and exercise eHealth intervention tailored to at-risk pregnant adolescents. RESEARCH PLAN: To accomplish these aims, Dr. Chang will conduct analyses using nationally representative data from the Fragile Families and Wellbeing Study; carry out social media mining and corresponding qualitative interviews with pregnant and postpartum adolescents; and design, implement, and evaluate an adolescent- centered and tailored eHealth (tailored text-messaging) intervention. CAREER DEVELOPMENT PLAN: Dr. Chang will broaden her knowledge of advanced statistical methods using a large nationally representative dataset; develop skills in mining and analyzing online social media data; acquire expertise in designing, implementing, and evaluating scalable interventions tailored to pregnant adolescents; and obtain experience in translating research findings into clinically relevant policies and practices. Dr. Chang's career development goals will be supported through close mentorship from an interdisciplinary team; guidance from an expert advisory panel; advanced didactic course work; attendance at professional meetings and workshops; participation in seminars and journal clubs; guidance in manuscript preparation and grant proposal development for projects arising from the research she conducts as part of this proposal; and implementing her research plan. This training will directly contribute to Dr. Chang's goal of addressing a vital intergenerational problem of excess pregnancy weight gain among at-risk adolescents, as well as the subsequent submission of a successful R01 application. ENVIRONMENT: Dr. Chang's unique resources include a dedicated and accomplished multi-disciplinary mentorship team with whom she has previously collaborated; the outstanding research infrastructure at the University of Michigan and Department of Family Medicine with a particular emphasis on supporting junior investigators; and numerous advanced didactic courses and seminars provided by several distinct academic units at the University of Michigan.
The US has one of the highest adolescent pregnancy rates in the developed world, and most pregnant adolescents in the US gain excess weight during pregnancy. Excess weight gain during pregnancy not only has a significant negative impact on the health of the adolescent mother, it increases the risk of dangerous complications during delivery, and contributes to long- term obesity for both mother and child. The overarching goal of this proposal is to promote healthy weight gain among pregnant adolescents by leveraging technologies adolescents use frequently, including online social media and text-messaging.
