Retaining the diverse CANDLE cohort to advance ECHO Cohort solution-oriented research and identify early-life modifiable risk factors for obesity and mental health problems in children

超过25%的儿童患有心理健康问题和/或发展为肥胖症。心理健康问题 在发展成抑郁症等疾病之前， 在美国，肥胖症影响了超过15%的青少年。 在青春期的22%。儿童疾病严重影响成人健康，令人震惊的是， 儿童心理健康问题和肥胖症正在增加，特别是有色人种青年。无数的早期生命风险 和保护因素，往往分布不均，并由COVID-19大流行更加引人注目， 与这些结果有关;然而，如果没有大规模的国家样本和系统的识别， 尽管存在优先因素，但预防性干预措施的明确目标仍然难以捉摸。为了解决这些关键问题，我们 跨学科团队利用ECHO队列数据的独特功能进行全环境扫描 青少年抑郁和肥胖的早期预测者，以确定和优先考虑最强大的目标， 预防，重点是性别特异性关联和改进因果推理（目标1）。我们还 一个发展知情的，假设驱动的方法来理解代际关系之间 母亲的童年和怀孕压力与儿童精神病理学风险，如果协会是性别- 具体或由家庭和社区一级的保护因素缓冲（目标2）。为此，我们计算一个新的， 专门的神经发育结果，p因子，它利用多个行为指标， 心理健康在儿童和青少年时期产生一般精神病理学的单一潜在因素。这 一种简约的、跨诊断的测量方法非常适合于基于人口的儿童发展研究， 缺乏深层的心理健康表型。最后，我们保留了社会经济和种族多样性的坎德尔 队列（64%非裔美国人，30%白色; ECHO计划（目标3）中的700对母子）。我们 成功收集ECHO队列数据和对多样性的贡献是不言而喻的：在69个ECHO队列中， CANDLE在非裔美国人参与者中排名第一，在ECHO的REDCap Central中排名第三。 我们的团队为协作科学做出了巨大贡献，领导多个工作组，出版和 传播欧共体人道处队列调查结果，支持计量发展和数据协调， 领导的努力。影响：我们将为预防目标提供强有力的证据， 这些因素，以减轻儿童心理健康问题和肥胖对公共卫生的影响。我们研究性- 具体的协会，并确保结果是普遍适用于青年的颜色，提高我们的潜力， 改善健康公平性。儿科精神病理学（p因子）的跨诊断测量将是 对许多研究人员都很有用，非常适合检查多次曝光。CANDLE研究 特别有助于ECHO队列的多样性，以及我们经验丰富的团队的持续领导和 欧共体人道处下一阶段的合作伙伴关系将促进合作科学，以改善儿童健康。

Over 25% of children suffer from mental health problems and/or develop obesity. Mental health problems often emerge early through a broad range of symptoms before canalizing into disorders like depression, which affects over 15% of adolescents in the U.S. Risk for obesity also increases with age from 13% in early childhood to 22% in adolescence. Childhood diseases greatly impact adult health, and alarmingly, rates of child mental health problems and obesity are increasing, particularly for youth of color. Myriad early life risk and protective factors, often inequitably distributed and made more striking by the COVID-19 pandemic, have been associated with these outcomes; however, without large national samples and systematic identification of priority factors, clear targets for preventive interventions remain elusive. To address these critical issues, our interdisciplinary team leverages the unique power of ECHO Cohort data to conduct environment-wide scans for early life predictors of adolescent depression and obesity to identify and prioritize the most powerful targets for prevention, with a focus on sex-specific associations and improving causal inference (Aim 1). We also take a developmentally-informed, hypothesis-driven approach to understand the intergenerational relations between maternal childhood and pregnancy stress with childhood psychopathology risk, and if associations are sex- specific or buffered by family and community-level protective factors (Aim 2). To do this, we calculate a new, specialized neurodevelopmental outcome, the p-factor, which draws on multiple indicators of behavior and mental health to generate a single latent factor of general psychopathology in childhood and adolescence. This parsimonious, transdiagnostic measure is ideally suited for population-based child development studies that lack deep mental health phenotyping. Finally, we retain the socioeconomically and racially diverse CANDLE cohort (64% African American, 30% White; 700 mother-child dyads in the ECHO Program (Aim 3). Our success collecting ECHO Cohort data and contributions to diversity are self-evident: of the 69 ECHO cohorts, CANDLE ranks #1 in African American participants and #3 in records contributed to ECHO’s REDCap Central. Our team strongly contributes to collaborative science, leading multiple working groups, publishing and disseminating ECHO Cohort findings, supporting measurement development and data harmonization, and co- leading DEI efforts. Impact: We will generate robust evidence for prevention targets, including protective factors, to mitigate the public health impact of child mental health problems and obesity. We examine sex- specific associations and ensure that results are generalizable to youth of color, enhancing the potential of our findings to improve health equity. A transdiagnostic measure of pediatric psychopathology (p-factor) will be useful to many investigators and is well-suited to the examination of multiple exposures. The CANDLE study notably contributes to the diversity of the ECHO Cohort, and our experienced team’s continued leadership and partnerships during the next phase of ECHO will advance collaborative science to improve child health.