Early Adversity, Childhood Educational Experiences, and Adulthood Physical Health

项目总结： 尽管教育程度和身体健康结果之间的联系--包括领导 死亡的原因，如心血管疾病，众所周知是巨大的，终生持续的 当然，在不同的性别、种族和民族中，几乎没有现有的研究能够 前瞻性地消除早期教育中最能预测成年身体健康的方面 从而在干预和预防工作中以最有效的目标为目标。同样，对该学派的研究也很少 背景也处于有利地位，可以在同一样本中纳入儿童早期风险的相关方面 家庭环境可能引发发育级联，导致较差的身体健康结果 通过童年教育经历进入成年期。为了解决这些限制，当前的应用程序是 旨在利用NICHD关于早期儿童保育和青年发展的里程碑式研究(SECCYD；1991- 2006)，这是一项大规模的前瞻性研究，到目前为止，从儿童出生起就对其进行了前瞻性跟踪，以评估生活 假设早年生活中的逆境会带来中等健康结果的风险的病程模型 与健康风险有关，部分是通过a)学业成绩和成就以及 B)儿童时期的教育经历(例如，教育经历的质量，包括人际和 具有指导性)。建立在NHLBI赞助的SECCYD女性亚样本后续行动的基础上 (待定R01HL130103，PI：BLEIL，从16年7月1日开始)，为当前应用程序提供资金将实现相同 对男性参与者的评估，包括健康/疾病风险的相关参数。这一努力将产生 一项针对750名SECCYD参与者(约50%男性，研究期间年龄在25-30岁之间)的高强度研究，假设 940名参与者的80%回报。后续访问将涉及心脏代谢和心脏代谢领域的评估 已知的炎症可预测因体检、抽血和 全面的病史/健康行为评估。这些新措施是从当前的 研究将与现有的、最先进的早期生活环境评估和 作为SECCYD原始数据收集的一部分获得的教育成就/经验 性别。早期生活逆境将使用童年社会自尊，婴儿-母亲依恋， 母亲的敏感、父亲的缺席、负性生活事件和虐待。学术成就将会是 评估使用教师报告的和客观的学术技能评估，而教育 将通过课堂观察和对质量的问卷评估来研究经验 老师和孩子之间的关系。总而言之，拟议的研究反映了一个独特的、对时间敏感的机会 从纵向上看，学业成绩和/或儿童教育经历的质量 独一无二地预测成年后的健康风险，以及探索儿童时期的中等和成年变量 调节这些预期关联的行为/生活方式变量。

PROJECT SUMMARY: Although the association between educational attainment and physical health outcomes—including leading causes of mortality like cardiovascular disease—is well known to be large in magnitude, enduring over the life course, and invariant across sex, race, and ethnicity, there are few existing studies that are capable of prospectively disambiguating aspects of early education that are most predictive of physical health in adulthood and thus most productively targeted in intervention and prevention efforts. Likewise, few studies of the school context are also well positioned to incorporate in the same sample correlated aspects of risk in children's early home environments that might initiate a developmental cascade resulting in poorer physical health outcomes in adulthood via childhood educational experiences. To address these limitations, the current application is designed to leverage the landmark NICHD Study of Early Child Care and Youth Development (SECCYD; 1991- 2006), a large-scale, prospective study of children thus far followed prospectively from birth, to evaluate a life course model whereby early life adversity is hypothesized to confer risk for intermediate health outcomes relevant to health risk partially through correlated variation in both a) academic achievement and attainment and b) educational experiences during childhood (e.g., the quality of educational experiences, both interpersonal and instructional in nature). Building on an NHLBI-sponsored follow-up of the female sub-sample of the SECCYD (pending R01HL130103, PI: Bleil, to begin 7/1/16), funding for the current application will enable identical assessments in the male participants including relevant parameters of health/disease risk. This effort will produce a high powered study of 750 total SECCYD participants (~50% male; ages 25-30 over study period), assuming 80% return of 940 participants. The follow-up visit will involve assessments in domains of cardio-metabolic and inflammation known to predict long-term risk for disease derived from a physical examination, blood draw, and comprehensive medical history/health behavior evaluation. These new measures generated from the current study will be examined in relation to existing, state-of-the-art assessments of early life environments and educational achievement/experiences acquired as a part of the original SECCYD data collection on both genders. Early life adversity will be characterized using measures of childhood SES, infant-mother attachment, maternal sensitivity, father absence, negative life events, and maltreatment. Academic achievement will be assessed using teacher-reported and objective assessments of academic skills whereas educational experiences will be studied using classroom observations along with questionnaire assessments of the quality of teacher-child relationships. In sum, the proposed study reflects a unique, time-sensitive opportunity to examine longitudinally the extent to which academic achievement and/or the quality of childhood educational experiences uniquely predict health risk in adulthood, as well as to explore childhood variables that moderate, and adult behavioral/lifestyle variables that mediate these prospective associations.