Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

项目总结/摘要 本ECHO COVID-19行政补充（NOT-OD-20-107）的总体目标是检查 儿童肥胖相关行为的变化与社会变化有关， COVID-19大流行。长时间的家庭住宿，身体距离预防措施，学校关闭， 经济中断可能会影响儿童的饮食摄入、身体活动、屏幕时间和睡眠。这是一 需要填补的关键空白，因为未来几年需要肥胖预防和治疗干预措施 专门针对COVID-19导致肥胖的原因。社会变化可能会对 来自不同社会经济和种族/族裔群体的儿童，反过来又加剧了现有的差距， 肥胖此外，保护措施的程度因美国各州而异，这可能有助于 这一流行病对儿童健康影响的地理差异。需要自然实验来评估 在社会经济、种族和地理上，流行病对肥胖相关行为的影响 使用严格的饮食，活动，屏幕时间和睡眠措施对不同的儿童样本进行研究。Kaiser Permanente北方加州（KPNC）是ECHO联盟中4个提议合作的获奖者之一 这份行政补充文件。我们提出了一个准实验的前测-后测设计， 来自4个ECHO研究中心队列的儿童二联体（n=375对二联体），包括KPNC，由两个出生前 目前正在跟踪儿童早期的后代。在预测试中，我们将利用现有的饮食数据， 活动，屏幕时间和睡眠从2020年3月之前完成ECHO访视的二人组中收集。为 在后测中，我们将在2020年秋季和2021年春季从相同的二人组中收集新的重复测量数据 使用远程数据收集。我们将解决以下具体目标：目标1：比较饮食，活动， 在大流行之前与大流行期间的筛查时间和睡眠，重点是确定高风险儿童 不利的变化。我们将探讨肥胖相关行为的变化是否受到以下因素的影响： 社会经济地位、种族/民族和研究中心位置：AIM 2：使用混合方法（定性和 定量），研究家庭在大流行期间的日常生活，以及父母对社会 变化会影响儿童与肥胖相关的行为。ECHO COVID问卷将定量 调查父母对社会变化如何影响肥胖相关行为的看法。定性访谈 与父母将确定COVID特定的障碍，以实现健康的行为，减少获得物理 促进积极玩耍的空间，以及父母对屏幕时间的依赖，以取代亲自日托。 这项研究将对ECHO和更广泛的儿童健康社区具有重要意义，因为生活方式行为 大流行期间的变化可能会改变肥胖风险，扩大现有的肥胖差距。时发现的问题 这项研究将为在大流行期间及以后预防儿童肥胖的计划、政策和实践提供信息。

PROJECT SUMMARY/ABSTRACT The overarching goal of this ECHO COVID-19 Administrative Supplement (NOT-OD-20-107) is to examine changes in children’s obesity-related behaviors that are occurring in tandem with societal changes related to the COVID-19 pandemic. Prolonged home stays, physical distancing precautions, school closures and economic disruption may impact children’s dietary intake, physical activity, screen time and sleep. This is a critical gap to fill because obesity prevention and treatment interventions over the next several years will need to be tailored to address the COVID-19-specific causes of obesity. Societal changes may differentially impact children from different socioeconomic and racial/ethnic groups and, in turn, exacerbate existing disparities in obesity. Further, variation in the degree of protective measures varies by US state, which may contribute to geographic variation in the effects of the pandemic on child health. Natural experiments are needed to assess the effects of the pandemic on obesity-related behaviors in a socioeconomically, ethnically and geographically diverse sample of children using rigorous measures of diet, activity, screen time and sleep. Kaiser Permanente Northern California (KPNC) is 1 of 4 awardees in the ECHO consortium proposing to collaborate on this Administrative Supplement. We propose a quasi-experimental pretest-posttest design among mother- child dyads from the 4 ECHO sites cohorts (n=375 dyads), including KPNC which consists of two pre-birth cohorts currently following offspring in early childhood. For the pretest, we will leverage existing data on diet, activity, screen time and sleep collected from dyads who completed their ECHO visit before March 2020. For the posttest, we will collect novel repeated measures data in Fall 2020 and Spring 2021 from the same dyads using remote data collection. We will address the following specific aims: AIM 1: to compare diet, activity, screen time and sleep prior to versus during the pandemic, with a focus on identifying children at high risk for adverse changes. We will explore whether the changes in obesity-related behaviors are modified by socioeconomic status, race/ethnicity and site location: AIM 2: using a mixed method approach (qualitative and quantitative), examine families’ daily routines during the pandemic, and parent perceptions of how societal changes influence children’s obesity-related behaviors. The ECHO COVID-questionnaire will quantitatively examine parent perceptions of how societal changes influence obesity-related behaviors. Qualitative interviews with parents will identify COVID-specific barriers to achieving healthy behaviors, reduced access to physical spaces that promote active play, and parents’ reliance on screen time as a replacement for in-person daycare. This study will be significant for ECHO and the broader child health community because lifestyle behavior changes during the pandemic may alter obesity risk and amplify existing obesity disparities. Findings from this study will inform programs, policy and practice to prevent childhood obesity during the pandemic and beyond.