Does Enhanced School-Readiness Affect Adult Health of African Americans?

描述(由申请者提供)：美国国立卫生研究院健康和科学研究挑战基金RFA-OD-09-003的数量增强的入学准备是否会影响非裔美国人的成年健康？本申请涉及广泛的挑战领域(05)比较有效性研究，05-MD-101，健康的社会决定因素。健康的社会决定因素被定义为人们生活在影响其身体健康的经济和社会条件下。加强就学准备是一种可能影响成年人健康的预防性干预措施。这项应用是对贫困儿童早期教育干预的两个随机试验的参与者进行的跟踪调查。对这些样本的长期跟踪数据提供了一个独特的机会，可以了解早期教育干预在多大程度上对以后的生活成功产生了积极影响。我们知道，早期教育干预改善了接受治疗的个人的认知测试成绩、学术技能和教育成就。该应用程序解决了这些好处可能在多大程度上扩展到与健康相关的行为和成年后的身体健康。初学者项目和卡罗莱纳响应性教育方法(CARE)是弗兰克·波特·格雷厄姆儿童发展研究所连续开展的儿童早期计划。在他们当中，177名婴儿(93.8%的非裔美国人)被登记并随机分配到早期治疗或控制条件下。在21岁时，92.6%的原始样本获得了成功的随访。研究样本现在的年龄在29岁到37岁之间。大多数人仍然住在当地。我们建议重新招募他们进行为期两年的成人健康和健康相关行为研究，以了解认知功能和经济指标的已知好处是否与他们的身体健康和健康实践中可检测到的差异有关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和先兆。我们打算为参与者提供完整的体检和实验室工作，并实施两份问卷：用于检查健康生活方式的行为风险因素调查，以及用于筛查心理健康的简短症状清单。这些成年人为他们自己的孩子提供的医疗保健也将被检查。 公共卫生相关性：NIH在健康和科学研究领域的挑战拨款数量RFA-OD-09-003本申请涉及广泛的挑战领域(05)比较有效性研究，05-MD-101，健康的社会决定因素。健康的社会决定因素被定义为人们生活在影响其身体健康的经济和社会条件下。我们对贫困儿童早期教育干预的随机试验符合解决这些决定因素的干预措施，我们的长期跟踪数据提供了一个独特的机会，让我们了解这些干预措施在多大程度上对他们的生活成功机会产生了积极影响。我们知道，这些干预措施改善了接受治疗的个人的认知测试成绩、学术技能和教育成就。该应用程序解决了这些好处可能在多大程度上扩展到与健康相关的行为和成年后的身体健康。20世纪70年代，弗兰克·波特·格雷厄姆儿童发展研究所(当时的“中心”)建立了两项儿童早期教育干预的随机对照试验。初级项目(ABC)将111名出生在低收入家庭的婴儿随机分配到全日制托儿环境中提供的教育干预计划中，或分配给未经治疗的对照组。治疗一直持续到5岁时进入幼儿园。1972年至1977年间，共招募了四组婴儿。紧随其后的是卡罗莱纳响应性教育研究(CARE)，在1978-1980年间招募了66名婴儿。CARE修改了全日制托儿治疗，增加了对父母的家庭教育(家访)。第二种治疗模式只提供家庭教育计划；CARE也有一个随机分配的控制组。因此，对后来发现的意向治疗分析允许在5组之间进行比较，但主要问题涉及接受基于儿童保育的教育干预的联合ABC组和保育组与联合ABC组和保育组之间的结果差异。早期儿童研究结果显示，在学龄前几年，接受基于儿童保育的早期干预的儿童在认知测试中获得了更高的分数，而那些参加ABC研究的儿童在学习测试(阅读和数学)上获得了更高的分数。作为年轻的成年人，与对照组相比，那些在ABC和CARE接受基于儿童护理的治疗的人有更高的教育水平，更有可能上大学，并且更有可能在一份有技能的工作中工作。研究样本现在的年龄在29岁到37岁之间。大多数人仍然住在当地。我们建议重新招募他们进行为期两年的成人健康和健康相关行为研究，以了解认知功能和经济指标的已知好处是否与他们的身体健康和健康实践中可检测到的差异有关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和先兆。我们打算为参与者提供完整的体检和实验室工作，并实施两份问卷：用于检查健康生活方式的行为风险因素调查，以及用于筛查心理健康的简短症状清单。这些成年人为他们自己的孩子提供的医疗保健也将被检查。

DESCRIPTION (provided by applicant): Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research Does Enhanced School-Readiness Affect Adult Health of African Americans? This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Enhanced school readiness is one preventive intervention that might impact health in adults. This application is to follow-up participants in two randomized trials of early childhood educational intervention for children born into poverty. Long-term follow-up data on these samples provide a unique opportunity to learn the extent to which early educational interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on later life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. The Abecedarian Project and the Carolina Approach to Responsive Education (CARE) were consecutive early childhood programs carried out at the Frank Porter Graham Child Development Institute. Between them, 177 infants (93.8% African American) were enrolled and randomly assigned to early treatment or to control conditions. At age 21, 92.6% of the original sample was successfully followed up. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined. PUBLIC HEALTH RELEVANCE: Number RFA-OD-09-003 NIH Challenge Grants in Health and Science Research This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, 05-MD-101, Social Determinants of Health. Social determinants of health are defined as the economic and social conditions under which people live that impact their physical well being. Our randomized trials of early childhood educational intervention for children born into poverty qualify as interventions that address these determinants, and our long-term follow-up data provide a unique opportunity to learn the extent to which such interventions, which we know improved cognitive test performance, academic skills, and educational attainment in treated individuals, have had positive impacts on their chances for life success. This application addresses the degree to which those benefits may have extended to health related behaviors and physical wellness in adulthood. Two randomized controlled trials of early childhood educational intervention were established at the Frank Porter Graham Child Development Institute (then "Center") in the 1970s. The Abecedarian project (ABC) randomly assigned 111 infants born into low income families either to an educational intervention program delivered in a full-time child care setting or to an untreated control group. Treatment lasted until kindergarten entry at age 5. Four cohorts of infants were enrolled between 1972 and 1977. The Carolina Approach to Responsive Education study (CARE) followed immediately, enrolling 66 infants in 1978-1980. CARE modified the full time child care treatment by adding to it Home Education (home visits) for parents. A second treatment model provided the Home Education program alone; CARE also had a randomly assigned control group. Thus, an intent-to-treat analysis of later findings allows for comparisons among 5 groups, but the primary question concerns the difference in outcomes between the combined ABC and CARE groups who received the child care based educational intervention compared with the combined ABC and CARE controls. Early childhood results showed that children who had the child care based early intervention earned higher scores on cognitive tests during the preschool years, and those in t he ABC study earned higher scores on academic measures (reading and mathematics). Followed up as young adults, those with child care based treatment in both ABC and CARE had higher levels of education, were more likely to attend college, and more likely to be working at a skilled job compared with the controls. The study samples are now between 29 and 37 years of age. Most still live in the local area. We propose to re-recruit them for a 2-year study of their adult wellness and health-related behaviors to learn if the known benefits in cognitive functioning and economic indicators are associated with detectable differences in their physical health and health practices. We will be looking for markers and precursors of cardiovascular disease, stroke, obesity, and diabetes. We intend to offer participants complete physical examinations with lab work, and to administer two questionnaires: the Behavioral risk Factor Survey to examine healthy life styles, and the Brief Symptom Inventory to screen for mental health. The health care these adults provide for their own children will also be examined.