Community Child Health Network: District of Columbia

描述（由申请人提供）：社区儿童健康网络（CCHN）第二阶段研究提出：（1）推进对产前发育过程、妊娠结局和幼儿发育（特别是身体发育、呼吸功能和语言发育）的生物医学、社会、行为和环境综合影响的理解。CCHN提出了一项5个地点的纵向研究，包括2个综合队列：对5250个家庭进行出生队列研究（每个地点1050个），然后进行随后的出生研究（38%的母亲预计随后会有活产）。这些研究侧重于压力和非稳态负荷的作用，由弹性和支持调节，对妊娠结局、胎儿编程和早产/宫内生长受限、超重、哮喘以及语言和认知发育的儿童发育结局;以及（2）通过社区参与式研究（CBPR），在研究的所有阶段发展并记录社区的积极参与-学术伙伴关系（CAPs）。这些发现旨在推进关于与怀孕和幼儿结局相关的健康差异的病因和影响的理论，并为未来预防干预措施的设计提供信息。创新功能包括：1）关注怀孕期间和怀孕前阶段; 2）在综合概念框架内结合生物医学和心理社会指标和成果; 3）多学科的复原力和支持措施以及风险; 4）将父亲作为怀孕和儿童健康成果的组成部分;以及5）社区和大学在地方和国家网络的参与性研究伙伴关系。哥伦比亚特区/乔治敦大学的网站带来了一个多合作伙伴的模式来承担实施上述拟议的研究。我们的网站增加了两个本地具体目标：a）为NIH研究人员和社区合作伙伴的全市联盟提供支持，以及B）帮助建立全市网络，以促进建立和共享与产前护理，分娩和分娩，孕间护理，幼儿健康和家庭社会服务有关的计算机数据库。这些地方目标的目标是帮助减少有据可查的健康差距，并制定和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.