Retaining the diverse CANDLE cohort to advance ECHO Cohort solution-oriented research and identify early-life modifiable risk factors for obesity and mental health problems in children

保留多样化的 CANDLE 队列，以推进 ECHO 队列以解决方案为导向的研究，并确定儿童肥胖和心理健康问题的早期可改变风险因素

• 批准号: 10745100
• 负责人: Nicole Renee Bush
• 金额: $ 150.59万
• 依托单位: UNIVERSITY OF TENNESSEE HEALTH SCI CTR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745100
• 关键词: Address; Adolescence; Adolescent; Adolescent obesity; Adult; Affect; African American; Age; Behavior; Buffers; COVID-19 pandemic; Chemicals; Child; Child Development; Child Health; Child Mental Health; Child Rearing; Childhood; Clinical; Clinical Psychology; Cohort Analysis; Collaborations; Color; Communities; Data; Data Element; Data Set; Development; Diagnostic; Disease; Early identification; Elements; Ensure; Environment; Epidemiology; Evaluation; Family; Future; Health; Inequity; Intergenerational Relations; Intervention; Lead; Leadership; Life; Measurement; Measures; Mental Depression; Mental Health; Methods; Mothers; Neighborhoods; Obesity; Outcome; Outcome Measure; Participant; Personal Satisfaction; Phase; Phenotype; Pregnancy; Prevention; Properdin; Protocols documentation; Psychopathology; Public Health; Publishing; Recommendation; Records; Research; Research Personnel; Risk; Risk Factors; Sampling; Scanning; Science; Specificity; Stress; Symptoms; Visit; age group; central database; child depression; children of color; cohort; data harmonization; depressive symptoms; disability-adjusted life years; early childhood; experience; health equity; improved; indexing; maternal stress; middle childhood; modifiable risk; novel; obesity risk; participant enrollment; physical conditioning; population based; preventive intervention; programs; protective factors; racial diversity; sex; social; sociodemographics; socioeconomics; study population; success; working group; years of life lost

Over 25% of children suffer from mental health problems and/or develop obesity. Mental health problems often emerge early through a broad range of symptoms before canalizing into disorders like depression, which affects over 15% of adolescents in the U.S. Risk for obesity also increases with age from 13% in early childhood to 22% in adolescence. Childhood diseases greatly impact adult health, and alarmingly, rates of child mental health problems and obesity are increasing, particularly for youth of color. Myriad early life risk and protective factors, often inequitably distributed and made more striking by the COVID-19 pandemic, have been associated with these outcomes; however, without large national samples and systematic identification of priority factors, clear targets for preventive interventions remain elusive. To address these critical issues, our interdisciplinary team leverages the unique power of ECHO Cohort data to conduct environment-wide scans for early life predictors of adolescent depression and obesity to identify and prioritize the most powerful targets for prevention, with a focus on sex-specific associations and improving causal inference (Aim 1). We also take a developmentally-informed, hypothesis-driven approach to understand the intergenerational relations between maternal childhood and pregnancy stress with childhood psychopathology risk, and if associations are sex- specific or buffered by family and community-level protective factors (Aim 2). To do this, we calculate a new, specialized neurodevelopmental outcome, the p-factor, which draws on multiple indicators of behavior and mental health to generate a single latent factor of general psychopathology in childhood and adolescence. This parsimonious, transdiagnostic measure is ideally suited for population-based child development studies that lack deep mental health phenotyping. Finally, we retain the socioeconomically and racially diverse CANDLE cohort (64% African American, 30% White; 700 mother-child dyads in the ECHO Program (Aim 3). Our success collecting ECHO Cohort data and contributions to diversity are self-evident: of the 69 ECHO cohorts, CANDLE ranks #1 in African American participants and #3 in records contributed to ECHO’s REDCap Central. Our team strongly contributes to collaborative science, leading multiple working groups, publishing and disseminating ECHO Cohort findings, supporting measurement development and data harmonization, and co- leading DEI efforts. Impact: We will generate robust evidence for prevention targets, including protective factors, to mitigate the public health impact of child mental health problems and obesity. We examine sex- specific associations and ensure that results are generalizable to youth of color, enhancing the potential of our findings to improve health equity. A transdiagnostic measure of pediatric psychopathology (p-factor) will be useful to many investigators and is well-suited to the examination of multiple exposures. The CANDLE study notably contributes to the diversity of the ECHO Cohort, and our experienced team’s continued leadership and partnerships during the next phase of ECHO will advance collaborative science to improve child health.

超过 25% 的儿童患有心理健康问题和/或出现肥胖问题。 通常在发展为抑郁症等疾病之前会出现一系列广泛的症状， 影响超过 15% 的美国青少年。肥胖风险也随着年龄的增长而增加，早期为 13% 儿童期至青春期的 22% 儿童疾病极大地影响了成人的健康，而且令人担忧的是，儿童疾病的发生率。 儿童心理健康问题和肥胖正在增加，特别是对于有色人种青少年来说，存在无数的早期生命风险。 保护性因素往往分布不均，并且因 COVID-19 大流行而变得更加引人注目 与这些结果相关；然而，没有大量的全国样本和系统的识别 为了解决这些关键问题，我们仍然难以确定预防性干预措施的优先因素和明确目标。 跨学科团队利用 ECHO 队列数据的独特力量进行环境范围扫描 针对青少年抑郁症和肥胖症的早期生命预测因素，确定最有力的目标并确定优先顺序 用于预防，重点关注特定性别的关联并改善因果推理（目标 1）。 一种基于发展的、假设驱动的方法来理解代际关系 母亲的童年和怀孕压力与儿童精神病理学风险有关，如果与性别有关 特定的或由家庭和社区层面的保护因素缓冲（目标 2）。 专门的神经发育结果，即 p 因子，它利用了多种行为指标和 心理健康是产生儿童期和青春期一般精神病理学的单一潜在因素。 简约的跨诊断措施非常适合基于人群的儿童发展研究 最后，我们保留了社会经济和种族多样性的 CANDLE。 队列（64% 非裔美国人，30% 白人；ECHO 计划中的 700 名母子二人组（目标 3）。我们的 成功收集 ECHO 队列数据以及对多样性的贡献是不言而喻的：在 69 个 ECHO 队列中， CANDLE 在非裔美国人参与者中排名第一，在 ECHO REDCap Central 贡献的记录中排名第三。 我们的团队为协作科学做出了巨大贡献，领导多个工作组、出版和 传播 ECHO 队列研究结果，支持测量开发和数据协调，以及 影响：我们将为预防目标（包括保护性目标）提供强有力的证据。 因素，以减轻儿童心理健康问题和肥胖对公共健康的影响。 特定协会，并确保结果可推广到有色人种青年，从而增强我们的潜力 改善健康公平性的研究结果将是儿科精神病理学（p因子）的跨诊断测量。 对许多研究人员有用，并且非常适合多重暴露的检查。 对 ECHO 群体的多样性做出了显着的贡献，我们经验丰富的团队的持续领导和 ECHO 下一阶段的合作伙伴关系将推进协作科学，以改善儿童健康。