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.

项目摘要 高风险怀孕和残疾儿童充实回声的总体目标（丰富 ECHO）队列是通过研究各种各样的儿童来提高回声研究中的残疾包容性 残疾并利用来自Echo残疾参与者的现有数据。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）和可修改 个人因素（例如，育儿风格，社会支持，心理健康）会影响身体和情感健康 残疾儿童的功能，福祉和参与社区的可确定结果 和家庭生活。我们的假设是，我们可以确定与更好的环境因素相关的特定环境因素 预计沿典型发展的连续残疾沿着残疾人的预期健康结果。丰富的cho 队列将通过以下特定目的解决这一假设： 目标1：利用回声核心数据元素，我们将（a）比较有和没有的儿童的轨迹 从出生到上学年龄（5-6岁），残疾随着时间的流逝，健康（儿童福祉）为主要 结果。我们将评估（b）产前环境和社会心理暴露的影响，以及（c） 随着时间的流逝，这些儿童队列中健康轨迹的出生营养，睡眠健康和体育活动。 目标2：在整个队列中（a）我们将确定与产妇前和周围的心理心理暴露相关的 在高风险和高风险和 简单的怀孕。 （b）我们将测试哪些前，周期和产后因素可以最好地预测主要因素 儿童福祉（积极健康）在学龄时的结果，调整了共同性效果。 （c）比较 有和没有残疾儿童的同类，我们将检查育儿风格和照顾者社交 支持是可修改的暴露，与预期的积极健康相关。 目标3：为了确保对回声科学的重要性和影响，增强的回声队列强调多样性 并通过使母亲和后代与一系列残疾的群体联系在一起，包括代表性不足的群体。我们的 方法将（a）招募患有高风险怀孕的参与者，他们最有可能分娩 残疾，包括经常被排除在研究中的残疾人。我们将（b） 与残疾人社区利益相关者合作设计参与，保留和传播 策略，以及（c）对各个队列的残疾人的早期回声监测标准化。 目标4：在第二次怀孕的回声参与者中，我们将探讨是否纳塔尔 与较老的兄弟姐妹中儿童健康相关的环境暴露（在AIM 2B中确定） 可以预测第二次回声怀孕期间产后出生结果。