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

描述（由申请人提供）：编号RFA-OD-09-003 NIH健康和科学研究挑战赠款增强入学准备是否影响非洲裔美国人的成年健康？此应用程序解决广泛的挑战领域（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影响人们身体健康的经济和社会条件。加强入学准备是一种可能影响成年人健康的预防性干预措施。本申请是对两项关于贫困儿童早期教育干预的随机试验的参与者进行随访。这些样本的长期随访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后期生活的成功产生了积极影响，我们知道早期教育干预可以改善接受治疗的个体的认知测试表现、学术技能和教育程度。该应用程序解决了这些益处可能扩展到成年期健康相关行为和身体健康的程度。初学者项目和卡罗莱纳回应教育方法（CARE）是弗兰克·波特·格雷厄姆儿童发展研究所连续开展的幼儿教育方案。其中，177名婴儿（93.8%为非洲裔美国人）被招募，并随机分配到早期治疗或对照条件。在21岁时，92.6%的原始样本成功随访。研究样本现在年龄在29岁至37岁之间。大多数人仍然生活在当地。我们建议重新招募他们进行为期2年的成年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益处是否与他们的身体健康和健康实践的可检测差异相关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和前兆。我们打算为参与者提供完整的身体检查和实验室工作，并管理两份问卷：行为风险因素调查，以检查健康的生活方式，以及简短的症状清单，以筛选心理健康。这些成年人为自己的子女提供的保健也将受到审查。 公共卫生相关性：编号RFA-OD-09-003美国国立卫生研究院健康与科学研究挑战赠款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影响人们身体健康的经济和社会条件。我们对出生于贫困家庭的儿童进行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，我们的长期随访数据提供了一个独特的机会，可以了解这些干预措施在多大程度上改善了认知测试成绩，学习技能和接受治疗的个人的教育程度，对他们的生活成功机会产生了积极影响。该应用程序解决了这些益处可能在多大程度上扩展到成年后与健康相关的行为和身体健康。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。Abecedarian项目（ABC）将111名出生于低收入家庭的婴儿随机分配到全日制儿童保育机构的教育干预计划或未经治疗的对照组。治疗持续到5岁进入幼儿园。1972年至1977年期间招募了四组婴儿。紧接着，卡罗莱纳的反应式教育方法研究（CARE）在1978-1980年间招募了66名婴儿。援外社通过增加对父母的家庭教育（家访），修改了全日制儿童保育治疗。第二种治疗模式仅提供家庭教育计划; CARE也有一个随机分配的对照组。因此，一个意向性治疗分析的后续结果允许5组之间的比较，但主要的问题是关注的结果之间的差异ABC和CARE组合组谁接受了儿童护理为基础的教育干预相比，ABC和CARE组合控制。早期儿童研究结果表明，接受基于儿童保育的早期干预的儿童在学龄前阶段的认知测试中获得了更高的分数，而ABC研究中的儿童在学术测量（阅读和数学）中获得了更高的分数。在年轻人之后，那些在ABC和CARE中接受儿童护理治疗的人与对照组相比，教育水平更高，更有可能上大学，更有可能从事技术工作。研究样本现在年龄在29岁至37岁之间。大多数人仍然生活在当地。我们建议重新招募他们进行为期2年的成年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益处是否与他们的身体健康和健康实践的可检测差异相关。我们将寻找心血管疾病、中风、肥胖和糖尿病的标志物和前兆。我们打算为参与者提供完整的身体检查和实验室工作，并管理两份问卷：行为风险因素调查，以检查健康的生活方式，以及简短的症状清单，以筛选心理健康。这些成年人为自己的子女提供的保健也将受到审查。

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.