Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure

了解环境对美国原住民儿童健康轨迹的风险梯度：毒物、免疫调节、代谢综合征、

• 批准号: 10745236
• 负责人: Johnnye L Lewis
• 金额: $ 448.94万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745236
• 关键词: Address; Affect; Agreement; Birth; Categories; Characteristics; Child; Child Development; Child Health; Clinical; Cohort Studies; Conceptions; Couples; Data; Data Set; Development; Diagnosis; Disease; Education; Elements; Ensure; Environment; Environmental Exposure; Evaluation; Exposure to; Family; Fertility; Health; Income; Indigenous; Language; Language Development; Learning; Life; Life Experience; Long COVID; Measures; Metabolic syndrome; Metal exposure; Metals; Minority Groups; Modeling; Native Americans; Native-Born; Navajo; Nutrient; Nutritional; Outcome; Outcome Measure; Parents; Participant; Patient Recruitments; Population; Population Study; Pregnancy; Prospective, cohort study; Protocols documentation; Recontacts; Reporting; Research; Risk; SARS-CoV-2 infection; Screening procedure; Source; Specific qualifier value; Time; Tribes; Update; Validity and Reliability; cohort; coronavirus disease; data sharing; experience; immunoregulation; innovation; instrument; interest; neurodevelopment; offspring; pandemic disease; participant enrollment; predictive modeling; programs; recruit; resilience; response; rurality; social communication; social determinants; sociodemographics; toxicant

SUMMARY The Navajo Birth Cohort Study (NBCS) is the first large-scale, well characterized prospective cohort study to assess the relationships between environmental exposures, birth outcomes, and child development in a tribal population. Representation of the Navajo population in the National ECHO cohort will contribute significantly to the understanding of risks to Indigenous populations through comparison of exposures and outcomes with other Indigenous populations and minority populations in ECHO, enhancing the understanding of the contributions of cultures with respect to both similarities and differences. Through participation in ECHO, the NBCS will build on the unique combination of characteristics to understand contributions of sociodemographic, nutritional, cultural, and exposure variables to health outcomes as well as to positive child health. We will ask research questions that take advantage of the size and diversity of the broader ECHO Cohorts to address key questions about how variables such as income, education, and rurality combine with exposure variables to contribute to health outcomes, including resiliency. We will assess language development, learning, social communication, and neurodevelopmental diagnosis over time to understand developmental trajectories and to ask how early-life experiences and exposures assessed through ECHO may influence these trajectories. We also ask questions about how the COVID-19 infection and the pandemic may have affected developmental trajectories, including potential long-covid effects. Over the course of the next 7 years in ECHO Cycle 2, we propose to contribute data on a cumulative total of 5300 participants, inclusive of pregnancies, offspring, conceiving partners, and current participants reconsented into the updated protocol. Our recruiting team has a deep understanding of the culture and life circumstances that exist for our study participants and employ multiple strategies to overcome existing barriers to participant recruitment, reconsent and retention. We propose to recruit a minimum of 30 couples per year into the preconception pilot to address how exposures during preconception to mixed metals or other toxicants of interest across ECHO, affect fertility, birth outcomes and developmental trajectories of offspring. Inclusion of NBCS in ECHO provides an opportunity to assess child health in a tribal population with diverse cultural practices and sociodemographics who experience significant exposures to toxicants. ECHO is one of the only sources where inclusion, even at a population- representative percentage, will allow for evaluation of child development relative to the US population overall. NBCS contributes to the diversity of ECHO through inclusion of a group traditionally underrepresented in population studies of this magnitude, yet adversely affected by exposures in all categories specified in ECHO, with outcomes of clinical concern in all key outcomes addressed through the ECHO core elements.

摘要 纳瓦霍出生队列研究(NBCS)是第一个大规模、特征良好的前瞻性队列研究 评估一个部落的环境暴露、出生结局和儿童发育之间的关系 人口。纳瓦霍人在国家回声队列中的代表将大大有助于 通过比较接触情况和结果，了解土著居民面临的风险 其他土著居民和少数族裔人口的呼应，增进了对 文化的贡献既有相似之处，也有差异。通过参与Echo， NBCS将建立在独特的特征组合基础上，以了解社会人口统计的贡献， 营养、文化和暴露变量对健康结果以及积极儿童健康的影响。我们会问 研究问题，利用更广泛的回声队列的规模和多样性来解决关键问题 关于收入、教育和乡村等变量如何与风险敞口变量相结合的问题 促进健康成果，包括复原力。我们将评估语言发展、学习、社交 随着时间的推移进行沟通和神经发育诊断，以了解发育轨迹并 询问早期生活经历和通过ECHO评估的暴露可能如何影响这些轨迹。我们 也要问一些关于新冠肺炎感染和大流行可能如何影响发育的问题 轨迹，包括潜在的长期冬季效应。在接下来的7年中，在第二个回声周期中，我们 提议提供累计5300名参与者的数据，包括怀孕、子女、 构思合作伙伴，目前的参与者重新同意更新后的议定书。我们的招聘团队有一支 深入了解我们的研究参与者和员工所处的文化和生活环境 多项战略，以克服现有的参与者招募、重新同意和留住方面的障碍。我们 建议每年至少招募30对夫妇参加先入为主的试点，以解决如何暴露 在怀孕前混合金属或其他感兴趣的毒物的回声，影响生育，生育结局 以及后代的发育轨迹。将NBCS纳入ECHO提供了评估的机会 在具有不同文化习俗和社会人口统计学经验的部落人口中的儿童健康 大量接触毒物。Echo是仅有的包容性的来源之一，即使在一个人口中- 代表性百分比，将允许评估相对于美国总人口的儿童发展。 NBCS通过纳入传统上在以下方面代表性较低的群体来促进ECHO的多样性 这种规模的人口研究，但受到ECHO规定的所有类别的暴露的不利影响， 通过ECHO核心要素解决所有关键结果中临床关注的结果。