Community Child Health Network: District of Columbia

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DESCRIPTION (provided by applicant): The Community Child Health Network (CCHN) Phase II research proposes to: (1) advance understanding of the combined biomedical, social, behavioral, and environmental influences on the course of prenatal development, pregnancy outcome, and early child development, particularly in physical growth, respiratory function, and language development. CCHN proposes a 5-site, longitudinal study of 2 integrated cohorts: a Birth Cohort Study of 5250 families (1050 per site)) followed by a Subsequent Birth Study (38 percent of mothers expected to have subsequent live birth). These studies focus on the role of stress and allostatic load, as moderated by resilience and supports, on pregnancy outcome, fetal programming, and child development outcomes of prematurity/intrauterine growth restriction, overweight, asthma, and language and cognitive development; and (2) to develop and document active community participation in all phases of the study through the community based participatory research (CBPR) in the community-academic partnerships (CAPs). The findings are intended to advance theory about the etiology and impact of health disparities related to pregnancy and early childhood outcomes, as well as inform the design of future preventive interventions. Innovative features include: 1) focus on the inter- and pre-conception period; 2) combining biomedical and psychosocial indicators and outcomes within an integrated conceptual framework; 3) multidisciplinary measures of resilience and supports as well as risks; 4) including fathers as integral to both pregnancy and child health outcomes; and 5) a participatory research partnership of the community and university at local sites and the national network. The District of Columbia/Georgetown University site brings a multi-partner model to bear to implement the above proposed research. Our site has added two local specific aims: a) to provide support for a citywide consortium of NIH researchers and community partners and b) to help build a citywide network to promote the establishment and sharing of computerized databases related to prenatal care, labor and delivery, interconceptional care, and early childhood health and family social services. The goal of these local aims is to help reduce the well-documented health disparities and to develop, then test promising interventions.