This grant will continue funding for a successful, 30-year training program in cardiovascular disease (CVD) prevention. The .purpose of the program is to train behavioral and medical scientists to conduct interdisciplinary research aimed at the prevention of CVD in communities. The training will be derived principally from direct research experience in an existing, excellent interdisciplinary research resource, the Stanford Prevention Research Center (SPRC), which includes community, policy, behavioral, and clinical research that totals $14 million annually. Current research includes studies comparing four popular weight loss diets for effects on weight and CVD risk over one year, the effects of garlic on CVD risk factors, exercise for preventing disability and improving quality of life in persons over 65, behavioral maintenance treatment in smoking cessation, selegiline for smoking cessation, retail tobacco marketing effects on adolescent smoking initiation, pro- and anti-smoking cues in stores and craving, the genetic epidemiology of CVD, neighborhood-level influences on mortality, improving CVD prevention practices in a county healthcare system, national trends in outpatient quality indicators, exercise and obesity prevention in adolescent girls, nutrition improvement in Hispanic families, environmental influences on exercise, and lifestyle interventions for older caregivers. The SPRC is also a clinical site for the Women's Health Initiative. Working closely with 1-2 faculty, trainees develop an individual research project, join an ongoing research program for tailored training experiences, conduct data analyses, and publish 2-3 papers per year. Directed study, a weekly research seminar, regular career development seminars, participation in grant preparation, selected course attendance, and limited patient care and teaching round out the training. Physician trainees will enter a specific track that includes a 1-year MS degree in epidemiology or in clinical investigation. Trainee selection is based on interest in cardiovascular disease prevention, potential, for an academic research career, and demonstrated excellence. We request eight postdoctoral positions for trainees who have either the M.D. or Ph.D. degree, or both. Of the 25 postdoctoral fellows completing training in the past 10 years, 18 (72%) are currently in academic or other research positions, or continued training (1);of the 34 postdoctoral trainees appointed in the past 10 years, 23 were women (68%) and 8 were underrepresented minorities (24%;4 Hispanic, 4 African-American). Two of these 8 continue in training and the other 6 completed the program and entered academic positions.
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