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. 2018 Nov;37(8):2951-2964.
doi: 10.1002/nau.23787. Epub 2018 Aug 22.

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Sonya S Brady  1 , Tamara G Bavendam  2 , Amanda Berry  3 , Cynthia S Fok  4 , Sheila Gahagan  5 , Patricia S Goode  6   7 , Cecilia T Hardacker  8   9 , Jeni Hebert-Beirne  10 , Cora E Lewis  11 , Jessica B Lewis  12 , Lisa Kane Low  13 , Jerry L Lowder  14 , Mary H Palmer  15 , Jean F Wyman  16 , Emily S Lukacz  17 ; Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium  17
Affiliations

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Sonya S Brady et al. Neurourol Urodyn. 2018 Nov.

Abstract

Aims: The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium was established by the National Institutes of Health in 2015 to expand research beyond the detection and treatment of lower urinary tract symptoms (LUTS) to the promotion and preservation of bladder health and prevention of LUTS in girls and women. While many multi-disciplinary scientific networks focus on pelvic floor dysfunction and LUTS, the PLUS Consortium stands alone in its focus on prevention. This article describes the PLUS approach to developing a conceptual framework to guide the Consortium's initial prevention research agenda.

Methods: The conceptual framework was informed by traditional social ecological models of public health, biopsychosocial models of health, Glass and McAtee's Society-Behavior-Biology Nexus, and the World Health Organization's conceptual framework for action on the social determinants of health.

Results: The PLUS conceptual framework provides a foundation for developing prevention interventions that have the greatest likelihood of promoting and preserving bladder health among diverse populations.

Conclusions: PLUS Consortium work is premised on the notion that programs, practices, and policies designed to promote health will have optimal impact if the conceptual foundation upon which efforts are based is comprehensive and informed by multiple disciplines. The PLUS conceptual framework is broadly applicable to domains of health that have historically focused on the treatment of illness and symptoms rather than the promotion of health. It is also applicable to domains of health that have been examined from a predominantly biological or social ecological perspective, without integration of both perspectives.

Keywords: bladder health; conceptual framework; girls; lower urinary tract symptoms; prevention; social ecology; women.

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Figures

Figure 1.
Figure 1.
Prevention of Lower Urinary tract Symptoms (PLUS) among girls and women: A conceptual framework adapted from Glass and McAtee (2006).
Figure 2.
Figure 2.
Sample conceptual model: Mechanisms by which schools and workplaces may influence bladder health and LUTS among girls and women (adapted from PLUS conceptual framework and Wang and Palmer, 2010).
See this image and copyright information in PMC

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