Community Child Health Network, Eastern North Carolina

描述（由申请人提供）：社区儿童健康网络（CCHN）第二阶段研究提出：（1）推进对产前发育过程、妊娠结局和幼儿发育（特别是身体发育、呼吸功能和语言发育）的生物医学、社会、行为和环境综合影响的理解。CCHN提出了一项5个地点的纵向研究，包括2个综合队列：对5250个家庭进行出生队列研究（每个地点1050个），然后进行随后的出生研究（38%的母亲预计随后会有活产）。这些研究侧重于压力和非稳态负荷的作用，由弹性和支持调节，对妊娠结局、胎儿编程和早产/宫内生长受限、超重、哮喘以及语言和认知发育的儿童发育结局;以及（2）通过社区参与式研究（CBPR），在研究的所有阶段发展并记录社区的积极参与-学术伙伴关系（CAPs）。这些发现旨在推进关于与怀孕和幼儿结局相关的健康差异的病因和影响的理论，并为未来预防干预措施的设计提供信息。创新功能包括：1）关注怀孕期间和怀孕前阶段; 2）在综合概念框架内结合生物医学和心理社会指标和成果; 3）多学科的复原力和支持措施以及风险; 4）将父亲作为怀孕和儿童健康成果的组成部分;以及5）社区和大学在地方和国家网络的参与性研究伙伴关系。北卡罗来纳州在早产、婴儿死亡率和获得医疗保健方面持续存在孕产妇和儿童健康差距。这些不良的生育结果不成比例地影响了该州东部农村地区的家庭。在这个以社区为基础的多层次研究项目中，合作伙伴将是妇女健康中心、妇女塞西尔G。Sheps健康服务研究中心，东卡罗莱纳大学医学院和健康与人类行为学院，以及东北卡罗来纳州婴儿爱加项目。东NC社区合作伙伴充分参与了研究规划，并将在本队列研究的启动、实施和分析中发挥关键作用

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 a 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. North Carolina persists in having maternal and child health disparities in preterm birth, infant mortality, and access to health care. These poor birth outcomes disproportionately affect families in the predominately rural Eastern part of the state. Partnered together in this community based, multilevel research project will be the UNC Center for Women's Health, the UNC Cecil G. Sheps Center for Health Services Research, East Carolina University School of Medicine and School of Health and Human Performance, as well as the Eastern North Carolina Baby Love Plus Project. Eastern NC community partners have participated fully in the research planning and will have crucial roles to play in the initiation, conduct, and analyses, of this cohort study