The Kentucky ECHO Pediatric IDeA Research Center (KE-PIRC)

项目摘要/摘要 作为一个以农村为主的州，肯塔基州在许多儿科和成人慢性病和 与环境有关的疾病，教育成就低，在全国名列前茅。这些不利因素 综合起来，肯塔基州人尤其是肥胖症、糖尿病、 吸烟、饮酒、心脏病、中风、肺癌等。这些疾病中的许多都是环保的 与营养不良、肥胖、吸烟、滥用药物和工作场所暴露有关。肯塔基州也在 有特殊保健需求的儿科人口所占的百分比在全国范围内是最大的。先前的研究表明， 大多数成人疾病都起源于儿童时期，有些开始于胎儿发育时期，使儿童时期 这是进行干预的理想时机，目的是改善成年后的健康状况。 改善儿童的医疗保健结果和健康状况取决于扩大和保持高 包括不同人群的高质量临床研究。路易斯维尔大学(UofL)儿科医生 我们的医疗合作伙伴为包括农村和城市穷人在内的高度多样化的患者群体提供服务， 独特的阿巴拉契亚社区、难民和众多少数民族。为了更好地服务于这群人，我们 建议在我们现有计划的基础上，扩大我们的双向社区参与努力， 通过ECHO IDEA儿科临床试验与其他机构合作进行儿科临床试验 网络，并与Echo Cohort、INBRE和CTSA站点合作，推进儿童医疗保健。 对当地和区域教职员工的教育和培训是维持这一倡议的关键。 肯塔基州ECHO-儿科IDEA研究中心(KE-PIRC)，作为IDEA州儿科临床的一部分 试验网络，将使1)农村和服务不足的婴儿、儿童和青少年 参与临床研究；2)初级研究人员接受临床研究和社区培训 参与，通过这项研究改善肯塔基州儿童和成年人的健康，并发展 他们的学术生涯；以及3)发展区域合作伙伴网络，以维持这一临床 研究主动性。五个主要关注领域是：1)产前、围产期和产后结局；2) 神经发育；3)上下呼吸道疾病；4)肥胖；5)积极健康。这些主要的 重点领域在肯塔基州非常普遍；因此，KE-PIRC将使当前 通过双向协作，加速州内新网络的发展 支持儿科临床研究的社区参与和反馈。通过这些努力，我们的目标是 改善肯塔基州儿童和成人的健康结果，并建立一个地方和国家可持续的 儿科临床研究队伍。

PROJECT SUMMARY/ABSTRACT As a predominantly rural state, Kentucky leads the nation in many pediatric and adult chronic and environmentally-related diseases and ‘ranks nationally’ in low educational achievement. These adverse factors combine to make Kentuckians especially unhealthy residents with a high prevalence of obesity, diabetes, smoking, alcohol use, heart disease, stroke, lung cancer, etc. Many of these diseases are environmentally related to poor nutrition, obesity, smoking, drug abuse, and work-place exposures. Kentucky also leads the nation in the percentage of pediatric populations with special health care needs. Prior work has shown that most adult diseases have their origin in childhood and some begin during fetal development, making childhood the ideal time for intervention with the goal of improving health outcomes into adulthood. Improving healthcare outcomes and wellness in children is contingent on expanding and sustaining high quality clinical research that includes diverse populations. Pediatricians at the University of Louisville (UofL) with our Healthcare Partners serve a highly diverse patient population that includes the rural and urban poor, a unique Appalachian community, refugees, and numerous ethnic minorities. To better serve this population, we propose to build upon our current programs, expand our bidirectional community engagement efforts, collaborate with other institutions on pediatric clinical trials through the ECHO IDeA Pediatric Clinical Trials Network, and collaborate with ECHO cohort, INBRE, and CTSA sites to advance healthcare for children. Education and training of local and regional faculty and staff is critical to sustain this initiative. The Kentucky ECHO-Pediatric IDeA Research Center (KE-PIRC), as part of the IDeA States Pediatric Clinical Trials Network, will make it possible for 1) rural and underserved infants, children and adolescents to participate in clinical research; 2) junior investigators to be trained in clinical research and community engagement, improve the health of both children and adults in Kentucky through this research, and develop their academic career; and 3) the development of a regional network of partners to sustain this clinical research initiative. The five primary focus areas are 1) pre-, peri- and postnatal outcomes; 2) neurodevelopmental; 3) upper and lower airway disease; 4) obesity; and 5) positive health. These primary focus areas are highly prevalent in Kentucky; therefore, KE-PIRC will enable strengthening current collaborations and accelerate the development of new networks within the state through bidirectional community engagement and feedback to support pediatric clinical research. Through these efforts, we aim to improve the health outcomes of Kentucky children and adults and establish a local and national sustainable pediatric clinical research workforce.