Enriching ECHO Cohorts with High-risk Pregnancies and Children with Disabilities (Enriching ECHO)

丰富高危妊娠和残疾儿童的 ECHO 队列 (Enriching ECHO)

• 批准号: 10746674
• 负责人: Judy Lynn Aschner
• 金额: $ 207.35万
• 依托单位: HACKENSACK UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10746674
• 关键词: Affect; Behavioral; Biology; Birth; Birth Weight; Caregivers; Child; Child Health; Child Rearing; Child Welfare; Cognitive; Collaborations; Communities; Congenital Abnormality; Data; Data Collection; Data Element; Detection; Development; Disabled Children; Disabled Persons; Discrimination; Early identification; Emotional; Ensure; Environmental Exposure; Environmental Risk Factor; Exclusion; Family; Future; Goals; Health; High-Risk Pregnancy; Intervention; Life; Longitudinal Studies; Mental Health; Mothers; Motor; Neuronal Plasticity; Outcome; Outcomes Research; Participant; Patient Recruitments; Perinatal; Personal Satisfaction; Physical activity; Policies; Population; Positioning Attribute; Pregnancy; Pregnancy Outcome; Protocols documentation; Publications; Research Design; Sample Size; School-Age Population; Science; Scientific Advances and Accomplishments; Scientific Inquiry; Sensory; Siblings; Social Environment; Social support; Societies; Standardization; Stress; Surveys; Testing; Time; Underrepresented Populations; Visit; adverse outcome; cohort; design; disability; dissemination strategy; diversity and inclusion; environmental enrichment for laboratory animals; equity, diversity, and inclusion; health equity; high risk; improved outcome; insight; nutrition; offspring; outcome prediction; postnatal; premature; prenatal; primary outcome; programs; psychosocial; public health relevance; recruit; research study; resilience; retention rate; sleep health; social health determinants

PROJECT SUMMARY The overarching goal of the Enriching ECHO with High-risk Pregnancies and Children with Disabilities (Enriching ECHO) cohort is to advance disabilities inclusivity in ECHO research by studying children with a spectrum of disability and by leveraging existing data from ECHO participants with disabilities. Our scientific premise is that psychosocial environmental exposures (e.g., SDH, stress, social environment, discrimination) and modifiable personal factors (e.g., parenting style, social supports, mental health) impact the physical and emotional health of children with disabilities resulting in definable outcomes of function, well-being, and participation in community and family life. Our hypothesis is that we can identify specific environmental factors associated with better -than- expected positive health outcomes along the continuumof disability to typical development. The EnrichingECHO cohort will address this hypothesis via the following specific aims: Aim 1: Leveraging ECHO core data elements, we will (a) compare trajectories of children with and without disabilities over time, from birth to school age (5-6 years), with positive health (child well-being) as the primary outcome. We will evaluate the effect of (b) pre-natal environmental and psychosocial exposures and (c) post- natal nutrition, sleep health, and physical activity on positive health trajectories in these child cohorts over time.. Aim 2: In the entire cohort (a) we will identify maternal pre- and peri-natal psychosocial exposures associated with post-natal outcomes (e.g., birth defects, birthweight, prematurity, early life disabilities) in high -risk and uncomplicated pregnancies. (b) We will test which pre-, peri-, and post-natal factors best predict the primary outcome of child well-being (positive health) at school-age, adjusting for co-linearity effects. (c) Comparing the cohorts of children with and without disability, we will examine whether parenting style and caregiver social support are modifiable exposures associated with better-than-expected positive health. Aim 3: To ensure significance and impact on ECHO science, the Enhancing ECHO cohort emphasizes diversity and inclusion of underrepresented groups by engaging mothers and offspring with a range of disabilities. Our approach will (a) recruit participants with high-risk pregnancies who are most likely to deliver children with disabilities and include individuals with disabilities who are often excluded from research studies. We will ( b) collaborate with community stakeholders with disabilities to design engagement, retention, and dissemination strategies, and (c) standardize early ECHO surveillance for disabilities across cohorts. Aim 4: In a cohort of ECHO participants with second pregnancies, we will explore whether the peri-natal environmental exposures associated with positive child health in the older ECHO sibling (identified in Aim 2b) are predictive of post-natal birth outcomes in the second ECHO pregnancy.

项目概要 丰富 ECHO 与高危妊娠和残疾儿童的总体目标（Enriching ECHO）队列旨在通过研究患有一系列残疾的儿童来促进 ECHO 研究中的残疾包容性 残疾并利用残疾 ECHO 参与者的现有数据。我们的科学前提是 心理社会环境暴露（例如 SDH、压力、社会环境、歧视）和可改变的 个人因素（例如养育方式、社会支持、心理健康）影响身心健康 残疾儿童在功能、福祉和社区参与方面取得明确的结果 和家庭生活。我们的假设是，我们可以识别与优于相关的特定环境因素 从残疾到典型发展的连续过程中预期的积极健康结果。丰富的ECHO 队列将通过以下具体目标来解决这一假设： 目标 1：利用 ECHO 核心数据元素，我们将 (a) 比较使用和不使用 ECHO 的儿童的轨迹 从出生到学龄（5-6 岁）一段时间内的残疾，以积极健康（儿童福祉）为首要 结果。我们将评估 (b) 产前环境和心理社会暴露以及 (c) 产后的影响 随着时间的推移，这些儿童群体的出生营养、睡眠健康和体力活动都呈现出积极的健康轨迹。 目标 2：在整个队列 (a) 中，我们将确定与母亲产前和围产期相关的社会心理暴露 高风险和低出生后结局（例如出生缺陷、出生体重、早产、早期残疾） 无并发症的妊娠。 (b) 我们将测试哪些产前、围产期和产后因素最能预测原发性 学龄儿童福祉（积极健康）的结果，调整共线性效应。 (c) 比较 对于残疾和非残疾儿童群体，我们将检查养育方式和照顾者的社交能力是否 支持是与好于预期的积极健康状况相关的可修改的暴露。 目标 3：为了确保 ECHO 科学的重要性和影响力，增强 ECHO 群体强调多样性 通过让患有一系列残疾的母亲和后代参与进来，包容代表性不足的群体。我们的 该方法将 (a) 招募高危妊娠的参与者，他们最有可能生下患有以下疾病的孩子： 残疾人，包括经常被排除在研究之外的残疾人。我们将 (b) 与残疾社区利益相关者合作，设计参与、保留和传播 (c) 标准化早期 ECHO 跨群体残疾监测。 目标 4：在第二次怀孕的 ECHO 参与者队列中，我们将探讨围产期是否 环境暴露与年长的 ECHO 兄弟姐妹的儿童健康状况良好相关（在目标 2b 中确定） 可以预测第二次 ECHO 妊娠的产后出生结果。