DYNAMICS OF CHILDHOOD OBESITY IN PENNSYLVANIA

项目概述：本研究将扩展现有数据和正在进行的研究，以了解生活在400个环境风险监管机构不同的社区的大量儿童中儿童肥胖的动态。利用来自大型初级保健卫生系统的综合电子健康记录，我们将使用多层次和系统动态模型来研究55,000多名儿童的肥胖动态。我们还将对来自80个社区的1150名儿童进行巢式亚研究，以检查环境特征、饮食和体育活动如何改变基因表达，这些基因表达是由位点特异性DNA甲基化捕获的，这将是迄今为止同类研究中规模最大的。我们还将采用由真实数据驱动的系统动态模型，模拟政策干预的流行病学后果，以提高或降低从早期模型中确定为肥胖决定因素的系统成分。

Project Summary: This study will extend existing data and ongoing research to understand the dynamics of childhood obesity in a large population of children living in 400 communities that vary on environmental risk regulators. Using a comprehensive electronic health record from a large primary care health system, we will use multilevel and system dynamic models to study the dynamics of obesity in over 55,000 children. We will also conduct a nested substudy of 1150 children from a subset of 80 communities to examine how features of the environment, as well as diet and physical activity alter gene expression as captured by locus-specific DNA methylation in what will be the largest study of its kind to date. We will also employ systems-dynamic models, motivated by real data, to simulate the epidemiologic consequences of policy interventions to up- or down regulate system components identified as determinants of obesity from earlier models.