Early Adversity, Childhood Educational Experiences, and Adulthood Physical Health

项目概要： 虽然教育程度和身体健康结果之间的联系-包括领导 众所周知，心血管疾病等死亡原因的严重性很大，持续一生 当然，在性别、种族和民族之间是不变的，很少有现有的研究能够 前瞻性地消除早期教育中最能预测成年后身体健康的方面的歧义 因此在干预和预防工作中最有成效。同样，对学校的研究也很少。 背景也很好地将儿童早期风险的相关方面纳入同一样本中。 家庭环境可能引发发育级联，导致身体健康状况较差， 通过童年的教育经历。为了解决这些限制，当前的应用是 旨在利用具有里程碑意义的NICHD早期儿童保育和青年发展研究（SECCYD; 1991- 2006年），一项大规模的前瞻性研究，迄今为止，儿童从出生起就前瞻性地跟踪，以评估生命 假设早期生活逆境会导致中间健康结果风险的过程模型 与健康风险有关，部分是通过a）学术成就和成就的相关变化， B）童年时期的教育经历（例如，教育经验的质量，包括人际关系和 性质上的指导性）。在国家HLBI赞助的对SECCYD女性子样本的跟踪基础上 （待定R 01 HL 130103，PI：Bleil，2016年7月开始），当前应用程序的资金将使相同的 男性参与者的评估，包括健康/疾病风险的相关参数。这一努力将产生 一项包含750名SECCYD参与者（约50%为男性;研究期间年龄为25-30岁）的高效能研究，假设 940名参与者的80%回报。随访访视将涉及心脏代谢和 已知炎症可预测来自体检、抽血和 综合病史/健康行为评价。这些新措施产生于目前的 研究将结合现有的、最先进的早期生命环境评估进行审查， 作为原始SECCYD数据收集的一部分获得的教育成就/经验， 性别早期生活逆境的特点是使用儿童社会经济地位，婴儿母亲的依恋， 母亲敏感、父亲缺席、负面生活事件和虐待。学术成就将是 评估使用教师报告和客观的评估学术技能，而教育 将通过课堂观察沿着问卷评估来研究经验， 师生关系。总之，拟议的研究反映了一个独特的，时间敏感的机会，审查 在纵向上，学术成就和/或儿童教育经历的质量 独特地预测成年后的健康风险，以及探索儿童时期的变量， 行为/生活方式变量介导这些前瞻性关联。

PROJECT SUMMARY: Although the association between educational attainment and physical health outcomes—including leading causes of mortality like cardiovascular disease—is well known to be large in magnitude, enduring over the life course, and invariant across sex, race, and ethnicity, there are few existing studies that are capable of prospectively disambiguating aspects of early education that are most predictive of physical health in adulthood and thus most productively targeted in intervention and prevention efforts. Likewise, few studies of the school context are also well positioned to incorporate in the same sample correlated aspects of risk in children's early home environments that might initiate a developmental cascade resulting in poorer physical health outcomes in adulthood via childhood educational experiences. To address these limitations, the current application is designed to leverage the landmark NICHD Study of Early Child Care and Youth Development (SECCYD; 1991- 2006), a large-scale, prospective study of children thus far followed prospectively from birth, to evaluate a life course model whereby early life adversity is hypothesized to confer risk for intermediate health outcomes relevant to health risk partially through correlated variation in both a) academic achievement and attainment and b) educational experiences during childhood (e.g., the quality of educational experiences, both interpersonal and instructional in nature). Building on an NHLBI-sponsored follow-up of the female sub-sample of the SECCYD (pending R01HL130103, PI: Bleil, to begin 7/1/16), funding for the current application will enable identical assessments in the male participants including relevant parameters of health/disease risk. This effort will produce a high powered study of 750 total SECCYD participants (~50% male; ages 25-30 over study period), assuming 80% return of 940 participants. The follow-up visit will involve assessments in domains of cardio-metabolic and inflammation known to predict long-term risk for disease derived from a physical examination, blood draw, and comprehensive medical history/health behavior evaluation. These new measures generated from the current study will be examined in relation to existing, state-of-the-art assessments of early life environments and educational achievement/experiences acquired as a part of the original SECCYD data collection on both genders. Early life adversity will be characterized using measures of childhood SES, infant-mother attachment, maternal sensitivity, father absence, negative life events, and maltreatment. Academic achievement will be assessed using teacher-reported and objective assessments of academic skills whereas educational experiences will be studied using classroom observations along with questionnaire assessments of the quality of teacher-child relationships. In sum, the proposed study reflects a unique, time-sensitive opportunity to examine longitudinally the extent to which academic achievement and/or the quality of childhood educational experiences uniquely predict health risk in adulthood, as well as to explore childhood variables that moderate, and adult behavioral/lifestyle variables that mediate these prospective associations.