The RISE FOR HEALTH study (RISE) was an initiative of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium to improve bladder health in women and girls. The RISE study examined the risk and protective factors for bladder health and lower urinary tract symptoms (LUTS) in a cohort of well-characterized women, and assessed the distributions of bladder health and bladder health knowledge, attitudes, and beliefs in women from across the nation. Importantly, RISE explored the influence of novel factors, such as the toileting environment, behaviors, and positions, on bladder health, using new measures developed by the PLUS Research Consortium. The study benefited from transdisciplinary contributions from community engagement and cross-cultural experts to ensure that RISE was responsive to the needs of community members and used measures that were reviewed for acceptability and comprehension in diverse women, including Spanish language speakers. Together, these features helped RISE to the foundation for knowledge about antecedent risk and protective factors for bladder health and LUTS, and inform future studies designed to promote bladder health and prevent LUTS in women.

The primary objective was to identify risk and protective factors for bladder health and LUTS in women of all ages across the life course.

The secondary objective was to estimate the distributions of bladder health and bladder health knowledge, attitudes, and beliefs in women of all ages across the life course.

Participation involved completion of two baseline surveys; the first including information on bladder health and bladder health knowledge, attitudes, and beliefs (approximately 30 minutes). The second baseline survey (also approximately 30 minutes) included information on additional candidate risk and protective factors. Both surveys were intentionally designed to be brief and separated in order to reduce participant burden. A subset of participants were invited to attend an in-person evaluation at baseline to collect clinical risk and protective factor information. This information was used primarily to evaluate prospective associations between candidate clinical and biologic risk and protective factors with changes in bladder health and risk of LUTS over time.

Inclusion criteria:

• Community dwelling in U.S. (non-institutionalized)
• Age ≥ 18 years
• Identify or born as female
• Able to read and understand English or Spanish and provide informed consent

Exclusion criteria:

• Physical or mental health conditions that would prohibit self-administration of questionnaires either electronically or using paper and pencil (e.g., dementia/cognitive impairment/blindness/severe arthritis)
• Residence in a nursing home or other institutionalized living facility

A wide range of bladder well-being and function, and high utilization of adaptive/coping behaviors was found. Bladder health variability and utilization of adaptive/coping behaviors was also observed in women without urinary symptoms, highlighting bladder health dimensions not captured by traditional urinary symptom tools and potentially identifying a group of women with “sub-clinical” symptoms who may be at greater risk of developing urinary symptoms. LUTS, particularly storage LUTS such as urgency and incontinence, were common and bothersome in the general female study population, yet often untreated. Given this large burden, both prevention and treatment-related interventions are warranted to reduce the high prevalence and symptoms of LUTS.