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

2/2 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: 10021744
• 负责人: LAUREN S WAKSCHLAG
• 金额: $ 26.44万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 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/10021744
• 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紧急科学和公众的支持 健康行动。母亲在围产期的使用/虐待尤其有害，因为它会产生反响 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、神经影像学和发育方面的进步的不利影响 敏感的表型测量现在可以表征典型和非典型的脑 行为途径达到前所未有的规模。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 需要一个庞大的全国性队列来解释地区和种族/民族的差异。我们 提议成立大脑在出生前开始（B4）中西部联盟，这是一个神经科学合作伙伴， 华盛顿大学物质使用、围产期心理健康和儿童福利科学家 医学院 (WUSM) 和神经科学、生物伦理学、儿科人口健康、孕产妇 西北大学 (NU) 的胎儿和成瘾科学家。随着科学 互补性，该区域联盟的优势在于其能够利用对比鲜明的地区 伊利诺伊州（惩罚性）和密苏里州（非惩罚性）对产前阿片类药物使用的方法，提供了 审查管辖权差异对科学和技术的影响的特殊平台 实践。我们共同提供了一个框架来解决关键的三个主要挑战领域 高质量、有代表性的国家多地点研究：(1) 法律/伦理：由 NU 生物伦理学领导 和人口健康专家，我们提出了一种混合方法来描绘障碍 并利用来自不同地区的孕妇制定阿片类药物科学参与的解决方案 司法管辖区； (2) 招聘/保留：由NU行为经济学专家领导 研究参与方法和 WUSM 专家在护理协调、儿童福利和 移动技术，我们使用创新方法来测试消息传递的差异有效性 使用眼动追踪的招聘材料，并采用新颖的应用程序和护理协调方法 用于增强保留； (3) 成像/评估方法：由神经科学和 WUSM 的物质使用专家和 NU 数据科学家，我们制定最佳实践 通过以下方式建议知情方案： (i) 试点测试全面的产前/围产期 孕产妇物质/心理健康协议； (ii) 获得 MRI 扫描的可行性数据 新生儿戒断综合征，还测试其他发育成像方式（例如脑电图、 fNIRS），包括在社区环境中； (iii) 应用最先进的流行病学风险 现有联盟数据的预测方法，以确定关键的方法和时间 提供附加预测价值的评估。所有活动都吸引了广泛的社区 利益相关者伙伴关系。我们的重点是产前-幼儿时期， 旨在为包括儿童后期在内的联盟做出有意义的贡献的框架。 从人口健康到神经科学的跨学科整合对于确保 全国范围内的大规模努力描绘了这种恶性流行病的影响和必然的风险 儿童和家庭的健康和发展才能得到充分实现。