1/2 - Optimizing access, engagement and assessment to elucidate prenatal influences on neurodevelopment: The Brains Begin Before Birth (B4) Midwest Consortium

1/2 - 优化获取、参与和评估以阐明产前对神经发育的影响：大脑在出生前开始 (B4) 中西部联盟

• 批准号: 9900193
• 负责人: CYNTHIA Elise ROGERS
• 金额: $ 26.54万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9900193
• 关键词: Accounting; Address; Adverse effects; Age; Alcohol or Other Drugs use; Area; Behavior assessment; Behavioral; Bioethics; Bioethics Consultants; Biological Assay; Birth; Brain; Catalogs; Categories; Child; Child Development; Child Welfare; Childhood; Clinical; Cognitive; Collaborations; Communities; Data; Data Scientist; Data Set; Development; Discipline; Effectiveness; Electroencephalography; Emotional; Ensure; Epidemic; Epidemiology; Equilibrium; Ethics; Exposure to; Eye; Family; Feedback; Fertilization; Follow-Up Studies; Fostering; Functional Magnetic Resonance Imaging; Goals; Health; Human; Illinois; Image; Individual Differences; Infant; Institution; Interview; Leadership; Legal; Link; Longitudinal Studies; MRI Scans; Manuscripts; Measurement; Mental Health; Methodology; Methods; Midwestern United States; Missouri; Modality; Modeling; Modification; Multimodal Imaging; Neonatal Abstinence Syndrome; Neurosciences; Opioid; Outcome; Pathway interactions; Pattern; Perinatal; Phase; Phenotype; Policies; Population; Postpartum Period; Predictive Value; Pregnant Women; Protocols documentation; Public Health; Recommendation; Reporting; Reproducibility; Research; Research Design; Research Personnel; Risk; Science; Scientist; Site; Social Interaction; Structure; Surveys; Testing; Universities; Variant; Washington; Woman; addiction; adverse outcome; age group; base; behavioral economics; brain behavior; care coordination; cohort; community setting; design; drug of abuse; early childhood; early life exposure; falls; fetal; high risk; imaging modality; infant morbidity/mortality; innovation; intergenerational; longitudinal design; medical schools; middle childhood; mobile application; mobile computing; multidisciplinary; neurodevelopment; neuroimaging; novel; offspring; opioid abuse; opioid epidemic; opioid use; opioid use in pregnancy; peer; perinatal mental health; phase 2 designs; population health; portability; postnatal; prenatal; prenatal exposure; prenatal influence; psychosocial; racial and ethnic; recruit; regional difference; relating to nervous system; research study; resilience; retention rate; risk prediction model; service providers; social; study population; treatment center; willingness

PROJECT SUMMARY: The accelerating U.S. opioid crisis requires urgent scientific and public health action. Maternal perinatal use/abuse is particularly deleterious due to its reverberating intergenerational impact. Though prenatal exposure to opioids and other substances have adverse effects on neurodevelopment, advances in neuroimaging and developmentally-sensitive phenotypic measurement now enable characterization of typical and atypical brain-behavior pathways on an unprecedented scale. Mechanistic study that traces the multi-level determinants and patterns of risk and resilience from the prenatal period through childhood requires a large, national cohort that accounts for regional and racial/ethnic variation. We propose the Brains Begin Before Birth (B4) Midwest Consortium, a partnership of neuroscience, substance use, perinatal mental health and child welfare scientists at Washington University School of Medicine (WUSM) and neuroscience, bioethics, pediatric population health, maternal-fetal and addiction scientists at Northwestern University (NU). Along with scientific complementarity, a strength of this regional Consortium is its ability to leverage the contrasting approaches of Illinois (punitive) and Missouri (non-punitive) to prenatal opioid use, providing an exceptional platform for examining the impact of jurisdictional variations on science and practice. Together, we provide a framework for addressing three major areas of challenge key to a high-quality, representative, national multi-site study: (1) Legal/Ethical: Led by NU bioethics and population health experts, we propose a mixed methods approach to delineating barriers and generating solutions to scientific engagement of opioid using pregnant women from varied jurisdictions; (2) Recruitment/Retention: Led by NU experts in behavioral economics approaches to research participation and WUSM experts in care coordination, child welfare and mobile technology, we use innovative methods to test differential effectiveness of messaging in recruitment materials using eye tracking, and employ novel apps and care coordination methods for retention enhancement; and (3) Imaging/Assessment Methods: Led by neuroscience and substance use experts at WUSM and an NU data scientist, we generate best practices recommendations for an informed protocol via: (i) pilot testing a comprehensive pre-/perinatal maternal substance/mental health protocol; (ii) obtaining feasibility data on MRI scans in neonatal abstinence syndrome, also testing other developmental imaging modalities (e.g., EEG, fNIRS), including in community settings; and (iii) applying state-of-the-art epidemiologic risk prediction methods to extant Consortium data to identify methods and timing of key assessments that provide added predictive value. All activities draw on extensive community stakeholder partnerships. Our central focus is the prenatal-early childhood period, with a framework designed to enable meaningful contributions to consortia including later childhood. Transdisciplinary integration spanning population health to neuroscience is essential to ensure that a large national effort delineating the impact of this pernicious epidemic and corollary risk on health and development of children and families can be fully realized.

项目摘要：加速的美国阿片类药物危机需要紧急科学和公共卫生行动。 孕产妇围产期使用/滥用由于其回荡的代际影响而尤其有害。尽管 产前暴露于阿片类药物和其他物质对神经发育有不利影响，进展 神经影像学和对发育敏感的表型测量现在可以表征典型 和非典型的脑行为途径在前所未有的尺度上。追踪多层次的机械研究 从产前期到儿童的决定因素和风险和韧性模式需要大量 占区域和种族/种族变化的国家队列。我们建议大脑在出生前开始 （B4）中西部财团，神经科学，药物使用，围产期心理健康和儿童的伙伴关系 华盛顿大学医学院（WUSM）和神经科学，生物伦理学，儿科科学家 西北大学（NU）的人口健康，孕产妇和成瘾科学家。以及科学 互补性，该区域财团的优势是其利用对比方法的能力 伊利诺伊州（惩罚性）和密苏里州（非态）用于产前阿片类药物，为 研究管辖权变化对科学和实践的影响。一起，我们为 解决挑战的三个主要领域的关键，用于高质量，代表，国家多站点研究：（1） 法律/道德：由NU生物伦理学和人口健康专家领导，我们提出了一种混合方法 使用孕妇从 各种司法管辖区； （2）招聘/保留：由NU专家在行为经济学方面领导的方法 研究参与和WUSM护理协调，儿童福利和移动技术的专家，我们使用 使用眼睛跟踪测试招聘材料中消息传递差异有效性的创新方法， 并采用新颖的应用程序和护理协调方法来增强保留； （3）成像/评估 方法：由WUSM的神经科学和药物使用专家和NU数据科学家领导，我们最佳 通过以下方式为知情协议提供建议 物质/心理健康方案； （ii）获得有关新生儿戒酒综合征中MRI扫描的可行性数据， 还测试其他发展成像方式（例如，脑电图，fnirs），包括在社区环境中；和 （iii）将最先进的流行病学风险预测方法应用于现存的财团数据以识别方法 以及提供增加预测价值的关键评估时间。所有活动都借鉴了广泛的社区 利益相关者合作伙伴关系。我们的核心重点是产前至童年时期，其框架设计为 为包括后期的童年为财团做出有意义的贡献。跨学科整合跨度 对神经科学的人口健康对于确保大量的国家努力描述了这一影响至关重要 可以充分实现对儿童和家庭健康和发展的有害流行病和推论风险。