Inequities in Childhood Life-Course Lead Exposure and Academic and Neurobehavioral Outcomes (I-CLEAN)

童年生命历程铅暴露以及学业和神经行为结果的不平等（I-CLEAN）

• 批准号: 10660566
• 负责人: Patricia Flores
• 金额: $ 60.11万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-09 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10660566
• 关键词: 10 year old; Address; Affect; Age; Age Months; Aggressive behavior; Attention; Awareness; Behavior; Binding; Biological Markers; Black race; Blood; California; Censuses; Child; Child Behavior; Child Behavior Checklist; Child Development; Child Health; Child Support; Childhood; Chronic; Cities; Cognitive; Communities; County; Data; Data Collection; Depressed mood; Development Plans; Eligibility Determination; Enrollment; Environment; Environmental Health; Equity; Etiology; Evidence based practice; Exposure to; Family; Fostering; Funding; Goals; Government; Health; Health Insurance; Household; Immigrant; Income; Individual; Industrialization; Inequity; Information Dissemination; Insurance; Intervention; Joints; Knowledge; Latina; Lead; Lead levels; Leadership; Legal system; Life; Life Cycle Stages; Link; Low income; Mathematics; Measurement; Measures; Metals; Modification; Neighborhoods; Neurologic; Neurotoxins; Oranges; Outcome; Outcome Measure; Outcome Study; Patient Recruitments; Performance; Policies; Population; Predisposition; Pregnancy; Prevalence; Prevention program; Process; Prospective cohort; Public Health; Questionnaires; Reading; Research; Resolution; Risk Factors; Schools; Science; Second Pregnancy Trimester; Series; Shapes; Soil; Source; Standardization; Strategic Planning; Symptoms; Syndrome; Time; Tooth structure; Translating; Universities; anxious; behavioral outcome; blood lead; childhood nervous system lead poisoning; chronic Pb exposure; community based participatory research; community organizations; contextual factors; deciduous tooth; design; eighth grade; elementary school; evidence base; health equity; health inequalities; implementation science; improved; kindergarten; lead exposure; neighborhood disadvantage; neurobehavioral; prevent; primary caregiver; remediation; response; screening; social; sociodemographic factors; socioeconomic disadvantage; soil lead; soil sampling; study population

Santa Ana in Orange County (OC), California (CA) is a predominantly Latina/o, immigrant and low-income community that is bound by multiple freeways, has a large industrial corridor, and has 65% of houses built prior to 1960. Residents of Santa Ana have identified lead (Pb) exposure in the community as a major environmental health concern. Responding to the concerns, we established the ¡Plo-NO! Santa Ana! (Lead-Free Santa Ana!) community-based participatory research partnership to examine elevated Pb levels in urban soil in Santa Ana since 2017. In this study, we propose to address the community-identified concerns of lead exposure and its impact on children’s health and academic performance using a community-based participatory research (CBPR) approach. We will also address important gaps in previous Pb research and practice, including 1) limited consideration of both life course exposure and susceptible time window for chronic low- level Pb exposure; 2) lack of research based on repeated outcome measures; 3) few studies on synergistic effect of metal mixtures; 4) few studies on multi-level (e.g. household, school, neighborhood) intervention; and 5) lack of community- driven research devoted to translating knowledge to effective public health equity strategies. Our overarching goal is to examine associations of life course and current Pb exposures with children’s academic performance and neurobehavioral outcomes, identify risk factors of current Pb exposure, and develop and implement a Public Health Equity Action Plan (PHEAP), with particular attention to health equity. Study population involves 600 children 7-10 years old at enrollment and their primary caregiver. Individual-level exposure to Pb and other metals will be estimated from 1) deciduous tooth-based exposure at a weekly resolution from the 2nd trimester of gestation up to the 1st year of life and every 6-months from age 1 up to the time when the tooth is shed; 2) blood for current exposure. Repeated outcomes include 5 years of academic performance and 3 years of behavior outcomes based on validated Child Behavior Checklist (CBCL) questionnaire. We will examine associations of academic performance and behavioral outcomes with deciduous teeth-based early life Pb exposure (Aim 1) and current blood Pb exposure (Aim 2). Further, we will develop, disseminate, implement, and evaluate a multi-level (e.g. household, school, neighborhood, city, county) Public Health Equity Action Plan, with a focus on equity (Aim 3). The strengths of this study include: bridging CBPR and implementation science by leveraging results from Aims 1-2 of this study and practice-based evidence to inform the PHEAP, responsiveness to community-driven priorities, strong community and university leadership, life course measurements of Pb and metal mixtures, a large prospective cohort with longitudinal measurements of both exposure and outcomes, and multiple levels of assessments (i.e. household, school, neighborhood) that advance the science on environmental health inequities to develop, evaluate, and pilot action plans and community-driven interventions. We will advance knowledge on how low levels of Pb exposure over the life course adversely affect children’s school performance and behavioral outcomes. The translational value of this study is noteworthy, as it integrates etiologic data and practice-based evidence to an equity- oriented multi-level action strategy to improve child academic and neurodevelopmental outcomes.

加利福尼亚州奥兰治县(OC)的圣安娜(Santa Ana)是一个以拉丁裔、移民和低收入为主的社区 那里有多条高速公路连接，有一条很大的工业走廊，65%的房屋都是在1960年之前建造的。北京的居民 圣安娜已经确定社区中的铅暴露是一个主要的环境健康问题。回应 顾虑，我们建立了“PLO-不！圣安娜！(无铅圣安娜！)基于社区的参与性研究 伙伴关系，检查自2017年以来圣安娜城市土壤中铅含量的升高。在这项研究中，我们建议解决 社区对铅暴露及其对儿童健康和学习成绩的影响的关注 基于社区的参与性研究(CBPR)方法。我们还将解决之前铅研究中的重要差距 和实践，包括1)有限地考虑生命过程暴露和慢性低血压的易感时间窗口。 铅暴露水平；2)缺乏基于重复结果测量的研究；3)很少有关于金属协同效应的研究 混合干预；4)关于多层次(如家庭、学校、邻里)干预的研究很少；5)缺乏社区- 致力于将知识转化为有效的公共卫生公平战略的驱动研究。我们的首要目标是 研究生命过程和当前铅暴露与儿童学习成绩和神经行为的关系 结果，确定当前铅暴露的风险因素，并制定和实施公共卫生公平行动计划 (Pheap)，特别关注健康公平。研究人群涉及600名7-10岁的儿童 注册及其主要照顾者。个人接触铅和其他金属的水平将从1) 从怀孕第二个月到出生第一年，以每周分辨率为基础的乳牙暴露 从1岁到牙齿脱落，每6个月一次；2)目前暴露的血液。重复的结果 包括5年的学习成绩和3年的基于有效儿童行为检查表的行为结果 (CBCL)问卷。我们将研究学习成绩和行为结果与乳汁分泌的关系。 牙齿早期铅暴露(目标1)和当前血铅暴露(目标2)。此外，我们还将开发、传播、 实施和评估多层次(如家庭、学校、邻里、市、县)公共卫生公平行动 计划，重点是公平(目标3)。这项研究的优势包括：通过以下方式将CBPR和实施科学联系起来 利用本研究的目标1-2的结果和基于实践的证据向Pheap提供信息，以响应 社区驱动的优先事项，强大的社区和大学领导，铅和金属的生命周期衡量 混合物，一个大型前瞻性队列，纵向测量暴露和结果，以及多个水平 评估(即家庭、学校、社区)，将环境健康不平等的科学发展到 制定、评估和试点行动计划和社区主导的干预措施。我们将进一步了解有多低 一生中铅暴露水平对儿童的学习成绩和行为结果产生不利影响。这个 这项研究的翻译价值值得注意，因为它将病因学数据和基于实践的证据整合到一个公平的- 有针对性的多层次行动战略，以改善儿童的学习和神经发育成果。