PROJECT ABSTRACT
Polycystic Ovary Syndrome (PCOS) affects 1 out of 10 women worldwide. While PCOS is
primarily characterized by menstrual irregularity and hyperandrogenemia, it is also associated
with multiple comorbidities – including diabetes, cardiovascular disease, depression, and
infertility – that lead to substantial morbidity and health care costs. A complex interaction
between adiposity, decreased insulin sensitivity, and increased androgen concentrations
underlies the pathophysiology of PCOS. These signs often first appear in early adolescence,
representing a key opportunity for preventive interventions. While physical activity is a promising
strategy for targeting the factors underlying PCOS development, there is a significant literature
gap regarding effective strategies for use in PCOS prevention. The goal of this proposal is to
identify the time course of changes in insulin dynamics and androgen concentrations in females
from mid-childhood through adolescence and the impact of physical activity during early
adolescence on these endpoints (Aim 1) and use implementation science methods to refine
(Aim 2) and pilot a targeted and evidence-based physical activity intervention in peripubertal
girls ages 8-10 at risk for PCOS while assessing the interventions’ feasibility, acceptability, and
preliminary efficacy in relation to physical activity levels, insulin sensitivity, and androgen
concentrations (Aim 3). The findings from this study will inform the development, dissemination,
and implementation of effective and scalable preventive interventions, a high priority area for the
NIDDK. Additionally, by specifically targeting young females at risk for later metabolic disease,
this proposal takes a life-course approach to chronic disease prevention. The PI, Dr. Whooten,
is an early career clinician investigator and pediatric endocrinologist, as well as health services
researcher. She will use this career development award to build her skills in (1) the longitudinal
analysis of epidemiological cohorts, (2) design and implementation of behavioral interventions
informed by an implementation science approach, and (3) collection and measurement of
objective behavioral and physiologic outcomes which will be essential for evaluating intervention
efficacy. Dr. Whooten will work closely with a multidisciplinary mentorship and advisory team
with expertise in epidemiology, objective measurement of health behaviors, measurement of
endocrine physiologic outcomes, implementation science, and biostatistics to carry out her
stated career objectives and specific aims.