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的圣安娜（CA）是一个主要是拉丁裔/O，移民和低收入社区 这受多个高速公路的约束，有一个庞大的工业走廊，并在1960年之前建造了65％的房屋。 圣安娜已将社区中的铅（PB）视为环境健康的主要问题。回应 担心，我们建立了“ Plo-no！圣安娜！ （无铅圣安娜！）基于社区的参与研究 自2017年以来，圣塔安娜城市土壤中PB水平升高的合作伙伴关系。在这项研究中，我们建议解决 使用社区确定的对潜在客户暴露及其对儿童健康和学习成绩的影响的担忧 基于社区的参与研究（CBPR）方法。我们还将解决以前的PB研究中的重要差距 和练习，包括1）慢性低 - PB级暴露； 2）缺乏基于重复结果指标的研究； 3）很少有关于金属协同作用的研究 混合物； 4）关于多层次（例如家庭，学校，邻里）干预的研究； 5）缺乏社区 - 驱动的研究致力于将知识转化为有效的公共卫生公平策略。我们的总体目标是 检查生活课程的关联和当前的PB暴露与儿童的学业表现和神经行为 结果，确定当前PB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岁儿童 入学人数及其主要护理人员。个人水平接触PB和其他金属将从1估计） 从妊娠第二学期到生命第一年的妊娠中期，以每周的分辨率为基础的牙齿暴露 从1岁到牙齿脱落的时间，每6个月; 2）血液当前暴露。重复的结果 包括5年的学习成绩和3年的行为成果，以经过验证的儿童行为清单 （CBCL）问卷。我们将研究学术绩效和行为成果的关联 基于牙齿的早期生命PB暴露（AIM 1）和当前的血液PB暴露（AIM 2）。此外，我们将发展，传播， 实施和评估多层（例如家庭，学校，邻里，城市，县）公共卫生公平行动 计划，重点是公平（AIM 3）。这项研究的优势包括：桥接CBPR和实施科学 利用这项研究的目标1-2的结果和基于实践的证据，以告知PHEAP，响应能力 社区驱动的优先事项，强大的社区和大学领导，PB和金属的生活课程测量 混合物，一个较大的前瞻性队列，具有纵向测量的暴露和结果，多个级别 评估（即家庭，学校，社区），将环境健康不平等科学提高到 制定，评估和试点行动计划以及社区驱动的干预措施。我们会促进了解多么低 生命课程的PB水平对儿童的学校表现和行为成果产生了不利影响。这 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公平 - 定向多层行动策略，以改善儿童学术和神经发育结果。