Longitudinal Trajectories of Adolescents Born Preterm

早产青少年的纵向轨迹

• 批准号: 7212258
• 负责人: Mary C Sullivan
• 金额: $ 27.77万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 2008-09-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7212258
• 关键词: Academy; Accounting; Activities of Daily Living; Adolescence; Adolescent; Adolescent Behavior; Adult; Affect; Age; Aging-Related Process; American; Attention; Attenuated; Behavior; Behavioral; Biological; Birth; Birth Weight; Buffers; Cerebral Palsy; Characteristics; Child; Childhood; Chronic Disease; Classification; Cognitive; Competence; Complex; Condition; Control Groups; Coupled; Data; Data Set; Detection; Development; Dimensions; Distress; Effectiveness; Employee Strikes; Environment; Environmental Risk Factor; Etiology; Exposure to; Face; Failure; Family; Follow-Up Studies; Foundations; Friendships; Funding; Goals; Grant; Growth; Health; Health Promotion; Healthy People 2010; Height; Heterogeneity; Homicide; Household; Incidence; Individual; Individual Differences; Infant; Intervention; Knowledge; Label; Language; Learning; Link; Literature; Longitudinal Studies; Low Birth Weight Infant; Measurement; Measures; Mediating; Medical; Medicine; Methods; Modeling; Morbidity - disease rate; Motivation; Motor; Music; National Institute of Nursing Research; Neighborhoods; Neurologic; Numbers; Obesity; Outcome; Overweight; Pathway interactions; Pattern; Performance; Perinatal; Personal Behavior; Personal Communication; Personal Satisfaction; Persons; Play; Policies; Poverty; Predisposition; Premature Birth; Premature Infant; Prematurity of fetus; Prevention; Principal Investigator; Problem behavior; Process; Purpose; Quality of life; Range; Rate; Relative (related person); Research; Research Design; Research Personnel; Risk; Risk Factors; Risk-Taking; Role; Sampling; School-Age Population; Schools; Science; Sex Behavior; Small for Gestational Age Infant; Social Behavior; Social Controls; Social Environment; Social support; Source; Sports; Substance abuse problem; Surveys; Survivors; System; Technology; Testing; Theoretical model; Time; Today; Very Low Birth Weight Infant; Weight; Work; age related; base; comparison group; contextual factors; early childhood; experience; follow-up; foot; functional outcomes; functional status; health related quality of life; high school; indexing; innovation; model development; mortality; motor deficit; nursing intervention; peer; programs; skills; social; social skills; success; vehicular accident

DESCRIPTION (provided by applicant): This research continuation into adolescence proposal is a request to follow a unique sample of children born at various degrees of prematurity and late medical risk. We have been following 192 families whose children were born at medical risk, from birth to age 12, with continual funding from NINR. This proposal incorporates the research directions established by the National Institute of Nursing Research's initiative and Healthy People 2010 to develop practice knowledge in health promotion for older children and adolescents. The proposed project is an innovative and unique effort to examine both the transition from early to late adolescence as well as the entire continuation of childhood in a sample of children born at various degrees of medical risk. Results from our research to date inclusive from birth to age 12, provide a comprehensive understanding of specific developmental trajectories and risk and protective processes that exacerbate or ameliorate the impact of cumulative risk on competency outcomes in full term and preterm children. The Specific Aims: (1) Investigate and model developmental trajectories from birth to age 18, in the sample of children born at various degrees of perinatal morbidity. The trajectories of growth, medical, neurological, motor and problem behavior. (2) Examine the models by which cumulative medical and environmental risk, from birth to age 12, have an independent effect on developmental competency constructs of health, academic, social and functional performance at last adolescence. (3) Examine how cumulative protective processes, from age 4 to 18, will have an independent effect and/or mediating effect on cumulative risk, on developmental competency constructs of health, academic, social, and functional performance at late adolescence. Compelling findings from our work support the need for trajectory follow up. For example, physical attainment at adolescence shows some "catch up" growth, yet preterm, especially SGA children, remain smaller and lighter than their peers at age 12. The rate of overweight and obesity rates were three to four times the national average in the preterm group ranging from 32% to 41%. In the motor trajectory, the incidence of motor deficits doubled from 11% at age 8 to 21% at age 12. Our most striking finding has been the importance of cumulative risk and cumulative protective processes heretofore undocumented, in the prediction of competency of early adolescence. Repeated measures using mixed effects models will be used to determine developmental trajectories and test the effects of risk and protection in determining health, academic functioning, and social competency outcomes at age 18. Late adolescence will be an important and necessary addition in developing a total model of development that incorporates both time-specific and cumulative risks as well as protective processes for an entire period of childhood. Such studies are urgently needed to build a broader scientific foundation for nursing interventions. This proposal is very specific in identifying connections between the literature, our prior studies, the need for trajectory follow through, and risk and protection in the understanding child competency outcomes. Based on the cutting edge work of our collaborators in risk contexts, we will develop models where cumulative risk and protective processes are highlighted.

描述(由申请者提供)：这项青春期研究的延续建议是要求跟踪不同程度的早产儿和晚产儿的独特样本。在NINR的持续资助下，我们一直在跟踪192个家庭，这些家庭的孩子从出生到12岁都有医疗风险。该提案纳入了国家护理研究所倡议和2010年健康人倡议确定的研究方向，目的是为年龄较大的儿童和青少年发展促进健康的实践知识。拟议的项目是一项创新和独特的努力，以不同程度的医疗风险出生的儿童为样本，研究从青春期早期到青春期后期的过渡以及整个童年的延续。到目前为止，我们的研究结果包括从出生到12岁，提供了对特定发育轨迹和风险和保护过程的全面了解，这些过程加剧或改善了累积风险对足月和早产儿能力结果的影响。具体目标：(1)调查和模拟从出生到18岁的不同围产期发病率儿童样本的发展轨迹。成长轨迹、医学、神经、运动和问题行为。(2)检验从出生到12岁的累积医疗和环境风险对青春期健康、学习、社会和功能表现的发展能力结构具有独立影响的模型。(3)研究从4岁到18岁的累积保护过程如何对累积风险、对青春期后期的健康、学业、社交和功能表现的发展能力结构产生独立影响和/或中介作用。我们工作中令人信服的发现支持轨迹跟踪的必要性。例如，青春期的身体素质表现出一定的追赶增长，但早产儿，特别是SGA儿童，在12岁时仍然比他们的同龄人更小、更轻。早产儿组的超重和肥胖率是全国平均水平的三到四倍，从32%到41%不等。在运动轨迹中，运动缺陷的发生率翻了一番，从8岁的11%增加到12岁的21%。我们最引人注目的发现是累积风险和累积保护过程在预测青春期早期能力方面的重要性。使用混合效应模型的重复测量将被用来确定发展轨迹，并测试风险和保护在决定18岁时的健康、学习功能和社会能力结果方面的效果。青春期后期将是一个重要和必要的补充，以建立一个包括特定时间和累积风险以及整个童年时期保护过程的总体发展模式。迫切需要这样的研究来为护理干预建立更广泛的科学基础。这一建议在确定文献、我们先前的研究、轨迹跟踪的必要性以及理解儿童能力结果的风险和保护之间的联系方面非常具体。基于我们的合作者在风险环境中的前沿工作，我们将开发突出累积风险和保护流程的模型。