Community Child Health Network, Eastern North Carolina

描述（由申请人提供）：社区儿童健康网络（CCHN）二期研究旨在：(1)进一步了解生物医学、社会、行为和环境对产前发育过程、妊娠结局和儿童早期发育的综合影响，特别是在身体发育、呼吸功能和语言发育方面。CCHN提出了一项5点、2个综合队列的纵向研究：一项5250个家庭的出生队列研究（每个站点1050个），然后是一项后续出生研究（38%的母亲预计后续活产）。这些研究主要关注应激和适应负荷在妊娠结局、胎儿规划和早产/宫内生长限制、超重、哮喘、语言和认知发展等儿童发育结局中的作用，并通过弹性和支持加以调节；(2)通过社区-学术伙伴关系（cap）中基于社区的参与性研究（CBPR），发展和记录社区在研究各个阶段的积极参与。这些发现旨在推进与妊娠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。创新特征包括：1)关注孕前期和孕间期；2)在综合概念框架内结合生物医学和社会心理指标和结果；3)弹性、支持和风险的多学科测量；4)将父亲纳入怀孕和儿童健康结果的组成部分；5)社区和大学在地方站点和国家网络上的参与性研究伙伴关系。北卡罗莱纳州在早产、婴儿死亡率和获得保健服务方面仍然存在孕产妇和儿童保健方面的差距。这些不良的出生结果对该州东部农村地区的家庭影响尤为严重。北卡罗莱纳大学妇女健康中心、北卡罗莱纳大学塞西尔·g·谢普斯健康服务研究中心、东卡罗莱纳大学医学院和健康与人类表现学院以及北卡罗莱纳东部婴儿爱加项目将共同参与这个以社区为基础的多层次研究项目。东部NC社区合作伙伴充分参与了研究计划，并将在这项队列研究的启动、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