Community Child Health Network, Eastern North Carolina

描述(由申请人提供)：社区儿童健康网络(CCHN)第二阶段研究建议：(1)促进对生物医学、社会、行为和环境在产前发育、妊娠结局和早期儿童发育过程中的综合影响的理解，特别是在身体生长、呼吸功能和语言发育方面。CCHN建议对2个综合队列进行5个站点的纵向研究：对5250个家庭(每个站点1050个)进行出生队列研究，然后进行后续的分娩研究(38%的母亲预计会有后续的活产)。这些研究的重点是压力和平衡负荷的作用，由复原力和支持对早产/宫内生长受限、超重、哮喘、语言和认知发展的妊娠结局、胎儿规划和儿童发展结局的影响；以及(2)通过社区-学术伙伴关系中的社区参与性研究(CBPR)，发展和记录社区在研究的所有阶段的积极参与。这些发现旨在推进与怀孕和儿童早期结局相关的健康差异的病因和影响的理论，并为未来预防干预的设计提供信息。创新特征包括：1)侧重于孕期和孕前阶段；2)在一个综合概念框架内结合生物医学和心理社会指标和成果；3)复原力和支助以及风险的多学科措施；4)将父亲作为孕期和儿童健康成果的组成部分；5)社区和大学在当地站点和国家网络建立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的机会方面一直存在孕产妇和儿童健康差距。这些糟糕的出生结果对该州以农村为主的东部地区的家庭造成了不成比例的影响。在这个以社区为基础的多层次研究项目中，合作伙伴将是北卡罗来纳大学妇女健康中心、北卡罗来纳大学塞西尔·G·谢普斯卫生服务研究中心、东卡罗来纳大学医学院和健康与人类行为学院，以及北卡罗来纳州东部的婴儿爱加项目。东部北卡罗来纳州社区合作伙伴充分参与了研究规划，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