1/2 - Optimizing access, engagement and assessment to elucidate prenatal influences on neurodevelopment: The Brains Begin Before Birth (B4) Midwest Consortium

1/2 - 优化获取、参与和评估以阐明产前对神经发育的影响：大脑在出生前开始 (B4) 中西部联盟

• 批准号: 9900193
• 负责人: CYNTHIA Elise ROGERS
• 金额: $ 26.54万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9900193
• 关键词: Accounting; Address; Adverse effects; Age; Alcohol or Other Drugs use; Area; Behavior assessment; Behavioral; Bioethics; Bioethics Consultants; Biological Assay; Birth; Brain; Catalogs; Categories; Child; Child Development; Child Welfare; Childhood; Clinical; Cognitive; Collaborations; Communities; Data; Data Scientist; Data Set; Development; Discipline; Effectiveness; Electroencephalography; Emotional; Ensure; Epidemic; Epidemiology; Equilibrium; Ethics; Exposure to; Eye; Family; Feedback; Fertilization; Follow-Up Studies; Fostering; Functional Magnetic Resonance Imaging; Goals; Health; Human; Illinois; Image; Individual Differences; Infant; Institution; Interview; Leadership; Legal; Link; Longitudinal Studies; MRI Scans; Manuscripts; Measurement; Mental Health; Methodology; Methods; Midwestern United States; Missouri; Modality; Modeling; Modification; Multimodal Imaging; Neonatal Abstinence Syndrome; Neurosciences; Opioid; Outcome; Pathway interactions; Pattern; Perinatal; Phase; Phenotype; Policies; Population; Postpartum Period; Predictive Value; Pregnant Women; Protocols documentation; Public Health; Recommendation; Reporting; Reproducibility; Research; Research Design; Research Personnel; Risk; Science; Scientist; Site; Social Interaction; Structure; Surveys; Testing; Universities; Variant; Washington; Woman; addiction; adverse outcome; age group; base; behavioral economics; brain behavior; care coordination; cohort; community setting; design; drug of abuse; early childhood; early life exposure; falls; fetal; high risk; imaging modality; infant morbidity/mortality; innovation; intergenerational; longitudinal design; medical schools; middle childhood; mobile application; mobile computing; multidisciplinary; neurodevelopment; neuroimaging; novel; offspring; opioid abuse; opioid epidemic; opioid use; opioid use in pregnancy; peer; perinatal mental health; phase 2 designs; population health; portability; postnatal; prenatal; prenatal exposure; prenatal influence; psychosocial; racial and ethnic; recruit; regional difference; relating to nervous system; research study; resilience; retention rate; risk prediction model; service providers; social; study population; treatment center; willingness

PROJECT SUMMARY: The accelerating U.S. opioid crisis requires urgent scientific and public health action. Maternal perinatal use/abuse is particularly deleterious due to its reverberating intergenerational impact. Though prenatal exposure to opioids and other substances have adverse effects on neurodevelopment, advances in neuroimaging and developmentally-sensitive phenotypic measurement now enable characterization of typical and atypical brain-behavior pathways on an unprecedented scale. Mechanistic study that traces the multi-level determinants and patterns of risk and resilience from the prenatal period through childhood requires a large, national cohort that accounts for regional and racial/ethnic variation. We propose the Brains Begin Before Birth (B4) Midwest Consortium, a partnership of neuroscience, substance use, perinatal mental health and child welfare scientists at Washington University School of Medicine (WUSM) and neuroscience, bioethics, pediatric population health, maternal-fetal and addiction scientists at Northwestern University (NU). Along with scientific complementarity, a strength of this regional Consortium is its ability to leverage the contrasting approaches of Illinois (punitive) and Missouri (non-punitive) to prenatal opioid use, providing an exceptional platform for examining the impact of jurisdictional variations on science and practice. Together, we provide a framework for addressing three major areas of challenge key to a high-quality, representative, national multi-site study: (1) Legal/Ethical: Led by NU bioethics and population health experts, we propose a mixed methods approach to delineating barriers and generating solutions to scientific engagement of opioid using pregnant women from varied jurisdictions; (2) Recruitment/Retention: Led by NU experts in behavioral economics approaches to research participation and WUSM experts in care coordination, child welfare and mobile technology, we use innovative methods to test differential effectiveness of messaging in recruitment materials using eye tracking, and employ novel apps and care coordination methods for retention enhancement; and (3) Imaging/Assessment Methods: Led by neuroscience and substance use experts at WUSM and an NU data scientist, we generate best practices recommendations for an informed protocol via: (i) pilot testing a comprehensive pre-/perinatal maternal substance/mental health protocol; (ii) obtaining feasibility data on MRI scans in neonatal abstinence syndrome, also testing other developmental imaging modalities (e.g., EEG, fNIRS), including in community settings; and (iii) applying state-of-the-art epidemiologic risk prediction methods to extant Consortium data to identify methods and timing of key assessments that provide added predictive value. All activities draw on extensive community stakeholder partnerships. Our central focus is the prenatal-early childhood period, with a framework designed to enable meaningful contributions to consortia including later childhood. Transdisciplinary integration spanning population health to neuroscience is essential to ensure that a large national effort delineating the impact of this pernicious epidemic and corollary risk on health and development of children and families can be fully realized.

项目总结：美国阿片类药物危机的加剧需要紧急的科学和公共卫生行动。