Cardiovascular Health Trajectories from Birth Thru Adolescence in A Diverse Cohort of Children

摘要 这项提案的首要目标是在不同的人群中确定从出生到20岁的CVH轨迹 7,000名已经有临床表型的儿童及其家人的队列，我们将在其中添加详细的 并对其进行纵向跟踪。使用创新的研究设计进行务实的队列利用 技术数据收集我们将从全市范围的电子健康中招募不同的儿童队列 芝加哥的记录(EHR)系统。父母/孩子将完成一项适合发育和临床的 一套可行的在线调查和问卷，以评估将与其相关的行为和生活方式 EHR数据已经在先前的研究中使用。两年后，我们将重新评估每个孩子的CVH。我们的 创新的加速纵向研究设计(ALD)将使我们能够定义CVH并为 不同的儿童群体，从出生到20岁，都在这笔赠款的5年内。这些轨迹将 然后被用来创建一种新的“CVH生长曲线”，准备用于临床实践。我们队有一支 完成这项研究的独特专业知识包括已经拥有芝加哥各地儿童的电子健康记录数据， 在队列招募和保留方面的专门知识，以及将研究CVH的领先专家纳入其中 孩子们。这项研究的发现将对针对高危儿童和 生命过程中的关键时期，以防止儿童CVH的丧失，并保存和 在整个生命过程中推广CVH。我们将开发一种临床工具，CVH生长曲线，它可以直接 转化为临床护理，并将为预防工作提供信息。我们的具体目标如下： 具体目标： 1.在不同的参与者队列中确定从出生到成年的CVH轨迹 (n=7,000)整个芝加哥 2.在不同的队列中确定从出生到成年的CVH轨迹的预测因素 参与者包括广泛的复原力和脆弱性标记物 3.制定准确、通用的心血管健康增长曲线，用于临床护理 有针对性地预防脑血管病和随后的心血管疾病的高危儿童

Abstract The overarching goal of this proposal is to identify CVH trajectories from birth through age 20 among a diverse cohort of 7,000 children and their families who already have clinical phenotyping to which we will add detailed behavioral data and follow them longitudinally. Using an innovative study design for a pragmatic cohort utilizing technology-enabled data collection we will recruit a diverse cohort of children from a city-wide electronic health record (EHR) system in Chicago. Parents/children will complete a developmentally appropriate and clinically feasible set of online surveys and questionnaires to assess behaviors and lifestyles that will be linked with their EHR data already being used in a prior study. After two years we will re-assess each child's CVH. Our innovative accelerated longitudinal study design (ALD) will allow us to define CVH and create trajectories for a diverse group of children from birth through age 20 all within the 5 years of this grant. These trajectories will then be used to create a novel “CVH growth curve” ready for use in clinical practice. Our team has the unique expertise to complete this study including already having the EHR data for children across Chicago, expertise in cohort recruitment and retention as well as inclusion of leading experts in studying CVH among children. The findings from this study will be critical in targeting prevention strategies to high-risk children and critical periods during the life course in order to prevent the loss of CVH in childhood and preserve and promote CVH across the life course. We will develop a clinical tool, CVH growth curves, that can be directly translated into clinical care and will inform prevention efforts. Our specific aims are as follows: Specific Aims: 1. Identify CVH trajectories from birth to young adulthood within a diverse cohort of participants (n=7,000) across the city of Chicago 2. Identify predictors of CVH trajectories from birth to young adulthood within a diverse cohort of participants including a broad range of markers of resilience and vulnerability 3. Develop an accurate and generalizable Cardiovascular Health Growth Curve for use in clinical care to target prevention to children at high risk of declining CVH and subsequent CVD