Community Child Health Network: District of Columbia

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：5250个家庭的出生队列研究（每个站点1050个），以及随后的出生研究（38%的母亲预计随后活产）。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。哥伦比亚特区/乔治城大学网站带来了一个多伙伴模式来承担实施上述建议的研究。我们的网站增加了两个当地的具体目标：a)为一个全市范围的NIH研究人员和社区合作伙伴联盟提供支持；b)帮助建立一个全市范围的网络，以促进建立和共享与产前护理、劳动和分娩、怀孕期间护理、幼儿健康和家庭社会服务有关的计算机数据库。这些地方目标的目标是帮助减少有据可查的健康差距，并制定并测试有希望的干预措施。

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.