Early determinants of childhood obesity: Etiology disparities policy analysis

项目摘要 到5岁时，超过10%的美国儿童患有肥胖症，来自少数民族的儿童甚至更多 处境不利的情况受到的影响不成比例。虽然有证据表明风险因素在 在观察性研究中，怀孕和早年与儿童肥胖有关，潜在的混杂 而受限制的小样本对推断因果关系构成了挑战。有关于在多大程度上 这些关系适用于所有种族/族裔群体。为支持健康行为而制定的政策实际上可能 如果只由某些种族/民族的母亲收养，肥胖风险因素的差异就会增加 集团或更有优势的集团。很少有研究解决这一问题。这个K99/R00奖将 为私家侦探提供一个机会，让她在流行病学背景的基础上再接再厉，并获得病因方面的培训 推理、政策评估，并通过正规课程和指导将研究转化为政策 由知名学者组成的跨学科小组。这个K奖的首要目标是澄清 研究儿童肥胖差异的出生后危险因素，并检查政策对儿童肥胖差异的影响。 这些风险因素。这项研究计划将通过最大限度地利用 通过数据链接利用公共数据，整合经济学和流行病学的分析技术，以 推断因果关系，了解对种族/民族和社会经济差异的影响，并确定政策 行为改变的驱动力。PI将通过链接马萨诸塞州的出生创建一个包含215,000名儿童的数据集 将证书数据存入健康儿童探视的电子数据库。在奖项的指导阶段(K99)， PI将检查母亲在怀孕期间吸烟、妊娠体重增加过多和 以及检查这些危险因素与肥胖相关结局之间的关系 在2岁和5岁时。在奖项的独立阶段(R00)，PI将审查以下方面的影响 关于这些风险因素的流行率以及种族/族裔和社会经济差异的政策，重点是 最近烟草控制政策和妊娠期增重建议的变化。政策和 马萨诸塞州和全国的儿童早期肥胖预防计划将被评估为 确定在多大程度上包括怀孕和早期生活中的因素。主办方将介绍 这一研究项目的结果将提供给州政府的政策制定者，并帮助确定未来的领域 肥胖症预防策略。PI将在获奖的第四年期间提交R01申请 继续追求这些方法和跨学科合作，目的是推动 关于妇幼保健差距的研究议程。

Project Summary By age 5, more than 10% of US children are obese and children from ethnic minority groups and more disadvantaged circumstances are disproportionately affected. While evidence exists that risk factors during pregnancy and early life are associated with childhood obesity, potential confounding in observational studies and small, restricted samples present challenges to infer causation. There is debate about the extent to which these relationships apply to all racial/ethnic groups. Policies enacted to support healthy behaviors may actually increase disparities in the risk factors for obesity if they are adopted only by mothers from certain racial/ethnic groups or more advantaged groups. Few studies have addressed this concern. This K99/R00 award will provide an opportunity for the PI to build on her background in epidemiology and acquire training in causal inference, policy evaluation, and translating research into policy through formal courses and mentorship by an interdisciplinary group of renowned scholars. The overarching goals of this K award are to clarify peri- and post-natal risk factors for disparities in childhood obesity and to examine the effects of policies on disparities in these risk factors. This program of research will move forward the field of obesity prevention by maximizing the utility of public data through data linkage, integrating analytic techniques from economics and epidemiology to infer causality, understanding influences on racial/ethnic and socioeconomic disparities, and identifying policy drivers for behavior change. The PI will create a dataset of 215,000 children by linking Massachusetts birth certificate data to an electronic database of well-child visits. During the mentored phase of the award (K99), the PI will examine disparities in maternal smoking during pregnancy, excessive gestational weight gain, and breastfeeding as well as examine the associations between these risk factors and adiposity-related outcomes at ages 2 and 5 years. During the independent phase of the award (R00), the PI will examine the influence of policies on the prevalence and racial/ethnic and socioeconomic disparities in these risk factors, focusing on recent changes in tobacco control policies and gestational weight gain recommendations. Policies and programs for early childhood obesity prevention both in Massachusetts and nationally will be assessed to determine the extent to which factors during pregnancy and early life are included. The PI will present the findings from this program of research to policy makers in state government and help identify areas for future obesity prevention strategies. The PI will submit an R01 application during the fourth year of the award to continue to pursue these methods and interdisciplinary collaborations with the aim of pushing forward the research agenda on disparities in maternal and child health.