Racial/Ethnic Disparities in Early Life Risk Factors for Childhood Obesity

描述（由申请人提供）：消除健康和保健方面的种族/民族差异是国家的优先事项，肥胖是主要目标。在过去的30年里，美国儿童肥胖的发病率急剧上升，任何年龄组都不例外。到学龄前，肥胖患病率的种族/民族差异已经存在，这表明儿童肥胖患病率的差异起源于生命的最初阶段。怀孕、婴儿期和幼儿期的几个危险因素已被发现与肥胖的发展有关。然而，很少有研究调查了这些产前和儿童早期肥胖风险因素的种族/民族差异。早期生活中肥胖风险因素的种族/民族差异可能是导致少数民族学龄前儿童及以后肥胖高发的原因。此外，在种族/少数民族人群中普遍存在的社会心理和社会压力因素可能导致增加肥胖风险的生理过程。母亲压力、种族主义经历和人际暴力是否会导致儿童肥胖及其风险因素仍未得到探索。本研究的总体目标是使用定量和定性方法来研究儿童肥胖早期生活危险因素的种族/民族差异。在这个项目的定量阶段，我们将研究非裔美国人、西班牙裔和白人儿童，他们是两个正在进行的美国国立卫生研究院资助的马萨诸塞州孕妇及其孩子队列研究的参与者：Viva项目和ACCESS项目（社区、环境和社会压力哮喘联盟）。总的来说，这些队列包括2000多个种族、民族和社会经济不同的母婴对。在本研究的定性阶段，我们将通过对怀孕、婴儿期和幼儿期的少数民族妇女进行焦点小组讨论来加强定量研究结果，进一步探讨早期生活肥胖相关危险因素差异的潜在原因。跨学科研究小组的成员完全有资格进行这项研究，因为他们率先开展了关于怀孕和产后肥胖起源的流行病学研究，并在检查健康和保健方面的种族/民族差异方面拥有丰富的经验。凭借其创新的设计、证据基础和可行性，拟议的研究很可能为预防儿童肥胖的干预开辟新的途径，而这正是美国人口中最需要的部分。

DESCRIPTION (provided by the applicant): Eliminating racial/ethnic disparities in health and health care is a national priority, and obesity is a prime target. During the last 30 years in the U.S., the prevalence of obesity among children has dramatically increased, sparing no age group. By the preschool years, racial/ethnic disparities in obesity prevalence are already present, suggesting that disparities in childhood obesity prevalence have their origins in the earliest stages of life. Several risk factors during pregnancy, infancy, and early childhood have been found to be associated with the development of obesity. However, few studies have examined racial/ethnic differences in these prenatal and early childhood risk factors for childhood obesity. It is possible that racial/ethnic differences in early life risk factors for obesity might contribute to the high prevalence of obesity among minority preschool age children and beyond. In addition, psychosocial and societal stressors, prevalent in racial/ethnic minority populations, may lead to physiologic processes that increase obesity risk. Maternal stress, experiences of racism and interpersonal violence remain unexplored as contributors to childhood obesity and its risk factors. The overall goal of this study is to use both quantitative and qualitative methods to study racial/ethnic disparities in early life risk factors for childhood obesity. In the quantitative phase of this project, we will study African-American, Hispanic, and white children who are participants of two, ongoing, NIH-funded, cohort studies of pregnant women and their children in Massachusetts: Project Viva and Project ACCESS (Asthma Coalition on Community, Environment, and Social Stress). Together, these cohorts comprise over 2000 racially, ethnically, and socioeconomically diverse mother-infant pairs. In the qualitative phase of this study, we will enhance our quantitative findings by conducting focus group discussions with racial/ethnic minority women during pregnancy, infancy, and early childhood to further probe the underlying reasons for disparities in early life obesity-related risk factors. The members of the interdisciplinary research team are well qualified to conduct the study, as they have pioneered epidemiologic studies on the origins of obesity during pregnancy and the postpartum period, and have extensive experience in examining racial/ethnic disparities in health and health care. With its innovative design, foundation in evidence, and feasibility, the proposed study may very well open up new avenues for interventions to prevent childhood obesity in the very segments of the US population who need it most.