Community Child Health Network: District of Columbia

描述(由申请人提供)：社区儿童健康网络(CCHN)第二阶段研究建议：(1)促进对生物医学、社会、行为和环境在产前发育、妊娠结局和早期儿童发育过程中的综合影响的理解，特别是在身体生长、呼吸功能和语言发育方面。CCHN建议对2个综合队列进行5个站点的纵向研究：对5250个家庭(每个站点1050个)进行出生队列研究，然后进行后续的生育研究(38%的母亲预计会有后续的活产)。这些研究的重点是压力和平衡负荷的作用，由复原力和支持对早产/宫内生长受限、超重、哮喘、语言和认知发展的妊娠结局、胎儿规划和儿童发展结局的影响；以及(2)通过社区-学术伙伴关系中的社区参与性研究(CBPR)，发展和记录社区在研究的所有阶段的积极参与。这些发现旨在推进与怀孕和儿童早期结局相关的健康差异的病因和影响的理论，并为未来预防干预的设计提供信息。创新特征包括：1)侧重于孕期和孕前阶段；2)在一个综合概念框架内结合生物医学和心理社会指标和成果；3)复原力和支助以及风险的多学科措施；4)将父亲作为孕期和儿童健康成果的组成部分；5)社区和大学在当地站点和国家网络建立参与性研究伙伴关系。哥伦比亚特区/乔治城大学网站引入了多方合作模式来实施上述拟议的研究。我们的网站增加了两个当地的具体目标：a)为全市范围内的NIH研究人员和社区合作伙伴联盟提供支持；b)帮助建立全市范围的网络，促进与产前护理、分娩和分娩、受孕期间护理以及幼儿健康和家庭社会服务相关的计算机化数据库的建立和共享。这些地方目标的目标是帮助减少有据可查的健康差距，并制定并测试有希望的干预措施。

DESCRIPTION (provided by applicant): The Community Child Health Network (CCHN) Phase II research proposes to: (1) advance understanding of the combined biomedical, social, behavioral, and environmental influences on the course of prenatal development, pregnancy outcome, and early child development, particularly in physical growth, respiratory function, and language development. CCHN proposes a 5-site, longitudinal study of 2 integrated cohorts: a Birth Cohort Study of 5250 families (1050 per site)) followed by a Subsequent Birth Study (38 percent of mothers expected to have subsequent live birth). These studies focus on the role of stress and allostatic load, as moderated by resilience and supports, on pregnancy outcome, fetal programming, and child development outcomes of prematurity/intrauterine growth restriction, overweight, asthma, and language and cognitive development; and (2) to develop and document active community participation in all phases of the study through the community based participatory research (CBPR) in the community-academic partnerships (CAPs). The findings are intended to advance theory about the etiology and impact of health disparities related to pregnancy and early childhood outcomes, as well as inform the design of future preventive interventions. Innovative features include: 1) focus on the inter- and pre-conception period; 2) combining biomedical and psychosocial indicators and outcomes within an integrated conceptual framework; 3) multidisciplinary measures of resilience and supports as well as risks; 4) including fathers as integral to both pregnancy and child health outcomes; and 5) a participatory research partnership of the community and university at local sites and the national network. The District of Columbia/Georgetown University site brings a multi-partner model to bear to implement the above proposed research. Our site has added two local specific aims: a) to provide support for a citywide consortium of NIH researchers and community partners and b) to help build a citywide network to promote the establishment and sharing of computerized databases related to prenatal care, labor and delivery, interconceptional care, and early childhood health and family social services. The goal of these local aims is to help reduce the well-documented health disparities and to develop, then test promising interventions.