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：美国阿片类药物危机的加剧需要采取紧急的科学和公共卫生行动。 母亲在围产期的使用/虐待尤其有害，因为它会产生代际影响。尽管 产前接触阿片类药物和其他物质对神经发育有不利影响， 神经影像和发育敏感的表型测量现在可以表征典型的 以及前所未有规模的非典型大脑行为途径。追溯多层次的机制研究 从产前时期到儿童期的风险和复原力的决定因素和模式需要大量、 解释区域和种族/民族差异的国家队列。我们建议大脑在出生前就开始 (B4) 中西部联盟，神经科学、物质使用、围产期心理健康和儿童的合作伙伴 华盛顿大学医学院 (WUSM) 的福利科学家以及神经科学、生物伦理学、儿科 西北大学 (NU) 的人口健康、母胎和成瘾科学家。随着科学 互补性，该区域联盟的优势在于其能够利用不同国家的不同方法 伊利诺伊州（惩罚性）和密苏里州（非惩罚性）对产前阿片类药物的使用提供了一个特殊的平台 研究管辖权变化对科学和实践的影响。我们共同提供了一个框架 解决高质量、有代表性的国家多地点研究的关键挑战的三个主要领域：(1) 法律/道德：在 NU 生物伦理学和人口健康专家的领导下，我们提出了一种混合方法 描绘孕妇使用阿片类药物的科学参与的障碍并制定解决方案 不同的司法管辖区； (2) 招聘/保留：由 NU 行为经济学专家领导 我们使用护理协调、儿童福利和移动技术方面的研究参与和 WUSM 专家 使用眼动追踪测试招聘材料中消息传递的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率； (3) 影像/评估 方法：在 WUSM 的神经科学和物质使用专家以及 NU 数据科学家的领导下，我们生成了最好的 通过以下方式实施知情方案的建议：(i) 对全面的产前/围产期产妇进行试点测试 物质/心理健康协议； (ii) 获得新生儿戒断综合征 MRI 扫描的可行性数据， 还测试其他发育成像模式（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有的联盟数据以确定方法 以及提供附加预测价值的关键评估的时间安排。所有活动都吸引了广泛的社区 利益相关者伙伴关系。我们的中心重点是产前-幼儿时期，其框架旨在 为包括儿童后期在内的联盟做出有意义的贡献。跨学科整合跨越 人口健康对神经科学至关重要，以确保全国范围内做出大规模努力来描述这一影响 可以充分认识到恶性流行病及其对儿童和家庭健康和发展的必然风险。