Does Enhanced School-Readiness Affect Adult Health of African Americans?

加强入学准备是否会影响非裔美国人的成年健康？

• 批准号: 7824462
• 负责人: FRANCES A. CAMPBELL
• 金额: $ 33.53万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-20 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7824462
• 关键词: 21 year old; Address; Adult; Affect; African; African American; Age; Age-Years; American; Anxiety; Area; Attention; Awareness; Behavior; Behavioral; Behavioral Risk Factor Surveillance System; Biological; Cardiovascular Diseases; Child; Child Care; Child Development; Cognitive; Control Groups; Data; Diabetes Mellitus; Early treatment; Economics; Education; Educational Background; Educational Intervention; Elderly; Endogenous depression; Enrollment; Equipment and supply inventories; Family; Grant; Health; Health Status; Health Surveys; Health behavior; Healthcare; Heart; Home environment; Home visitation; House Call; Hypertension; Individual; Infant; Institutes; Intervention; Interview; Laboratories; Learning; Life; Life Style; Low income; Mathematics; Measurement; Measures; Mental Health; Modeling; Nursery Schools; Obesity; Occupations; Outcome; Parents; Participant; Physical Examination; Poverty; Preventive Intervention; Qualifying; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Readiness; Reading; Recording of previous events; Recruitment Activity; Risk; Risk Factors; Risk Reduction; Risk Reduction Behavior; Sampling; Sampling Studies; Schools; Severities; Social Conditions; Stroke; Surveys; Symptoms; Testing; Time; United States National Institutes of Health; Work; base; cognitive function; cohort; college; comparative effectiveness; depression; diabetes risk; early childhood; effectiveness research; follow-up; health science research; heart disease risk; improved; intergenerational; intervention program; kindergarten; performance tests; physical conditioning; programs; prophylactic; public health relevance; skills; social health determinants; success; young adult

DESCRIPTION (provided by applicant): Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research Does Enhanced School-Readiness Affect Adult Health of African Americans? This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Enhanced school readiness is one preventive intervention that might impact health in adults. This application is to follow-up participants in two randomized trials of early childhood educational intervention for children born into poverty. Long-term follow-up data on these samples provide a unique opportunity to learn the extent to which early educational interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on later life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. The Abecedarian Project and the Carolina Approach to Responsive Education (CARE) were consecutive early childhood programs carried out at the Frank Porter Graham Child Development Institute. Between them, 177 infants (93.8% African American) were enrolled and randomly assigned to early treatment or to control conditions. At age 21, 92.6% of the original sample was successfully followed up. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined. PUBLIC HEALTH RELEVANCE: Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Our randomized trials of early childhood educational intervention for children born into poverty qualify as interventions that address these determinants, and our long-term follow-up data provide a unique opportunity to learn the extent to which such interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on their chances for life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. Two randomized controlled trials of early childhood educational intervention were established at the Frank Porter Graham Child Development Institute (then "Center") in the 1970s. The Abecedarian project (ABC) randomly assigned 111 infants born into low income families either to an educational intervention program delivered in a full-time child care setting or to an untreated control group. Treatment lasted until kindergarten entry at age 5. Four cohorts of infants were enrolled between 1972 and 1977. The Carolina Approach to Responsive Education study (CARE) followed immediately, enrolling 66 infants in 1978-1980. CARE modified the full time child care treatment by adding to it Home Education (home visits) for parents. A second treatment model provided the Home Education program alone; CARE also had a randomly assigned control group. Thus, an intent-to-treat analysis of later findings allows for comparisons among 5 groups, but the primary question concerns the difference in outcomes between the combined ABC and CARE groups who received the child care based educational intervention compared with the combined ABC and CARE controls. Early childhood results showed that children who had the child care based early intervention earned higher scores on cognitive tests during the preschool years, and those in t he ABC study earned higher scores on academic measures (reading and mathematics). Followed up as young adults, those with child care based treatment in both ABC and CARE had higher levels of education, were more likely to attend college, and more likely to be working at a skilled job compared with the controls. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined.

描述（由申请人提供）：编号 RFA-OD-09-003 NIH 健康和科学研究挑战拨款 增强入学准备是否会影响非裔美国人的成人健康？该应用程序解决了广泛的挑战领域 (05) 比较有效性研究，05-MD-101，健康的社会决定因素。健康的社会决定因素被定义为影响人们身体健康的经济和社会条件。加强入学准备是一种可能影响成年人健康的预防性干预措施。该应用程序旨在跟踪两项对贫困儿童进行幼儿教育干预的随机试验的参与者。对这些样本的长期跟踪数据提供了一个独特的机会来了解早期教育干预在多大程度上对后来的生活成功产生了积极影响，我们知道早期教育干预可以改善接受治疗的个体的认知测试表现、学术技能和教育程度。该应用程序解决了这些益处可能扩展到成年后的健康相关行为和身体健康的程度。初学者项目和卡罗来纳响应式教育方法 (CARE) 是弗兰克·波特·格雷厄姆儿童发展研究所连续开展的幼儿项目。其中，有 177 名婴儿（93.8% 为非裔美国人）被招募并随机分配到早期治疗或对照条件组。 21岁时，92.6%的原始样本被成功随访。研究样本目前年龄在 29 岁至 37 岁之间。大多数人仍然居住在当地。我们建议重新招募他们进行为期两年的成人健康和健康相关行为研究，以了解认知功能和经济指标方面的已知益处是否与他们的身体健康和健康实践中可检测到的差异相关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和先兆。我们打算为参与者提供完整的体检和实验室工作，并管理两份问卷：用于检查健康生活方式的行为风险因素调查和用于筛查心理健康状况的简短症状清单。这些成年人为自己的孩子提供的医疗保健也将受到检查。 公共健康相关性：编号 RFA-OD-09-003 NIH 健康和科学研究挑战资助 本申请解决了广泛的挑战领域 (05) 比较有效性研究，05-MD-101，健康的社会决定因素。健康的社会决定因素被定义为影响人们身体健康的经济和社会条件。我们对出生于贫困的儿童进行的幼儿教育干预随机试验符合解决这些决定因素的干预措施，我们的长期随访数据提供了一个独特的机会来了解这些干预措施在多大程度上改善了接受治疗的个体的认知测试表现、学术技能和教育程度，对他们人生成功的机会产生了积极影响。该应用程序解决了这些益处可能扩展到成年后的健康相关行为和身体健康的程度。弗兰克·波特·格雷厄姆儿童发展研究所（当时的“中心”）于 20 世纪 70 年代建立了两项早期儿童教育干预的随机对照试验。 Abecedarian 项目 (ABC) 将出生于低收入家庭的 111 名婴儿随机分配到全日制托儿所提供的教育干预计划或未经治疗的对照组。治疗一直持续到 5 岁进入幼儿园。1972 年至 1977 年间招募了四组婴儿。卡罗莱纳响应式教育方法研究 (CARE) 紧随其后，在 1978 年至 1980 年期间招募了 66 名婴儿。 CARE 修改了全日制托儿服务，增加了对父母的家庭教育（家访）。第二种治疗模式仅提供家庭教育计划； CARE 还有一个随机分配的对照组。因此，对后来发现的意向治疗分析允许在 5 个组之间进行比较，但主要问题涉及接受基于儿童保育的教育干预的 ABC 和 CARE 组合组与 ABC 和 CARE 组合对照组相比的结果差异。早期儿童研究结果表明，接受基于儿童保育的早期干预的儿童在学前阶段的认知测试中获得了更高的分数，而 ABC 研究中的儿童在学业指标（阅读和数学）上获得了更高的分数。在 ABC 和 CARE 中接受基于儿童保育治疗的年轻人的随访中，与对照组相比，他们的教育水平更高，更有可能上大学，并且更有可能从事技术工作。研究样本目前年龄在 29 岁至 37 岁之间。大多数人仍然居住在当地。我们建议重新招募他们进行为期两年的成人健康和健康相关行为研究，以了解认知功能和经济指标方面的已知益处是否与他们的身体健康和健康实践中可检测到的差异相关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和先兆。我们打算为参与者提供完整的体检和实验室工作，并管理两份问卷：用于检查健康生活方式的行为风险因素调查和用于筛查心理健康状况的简短症状清单。这些成年人为自己的孩子提供的医疗保健也将受到检查。