Understanding Risk Gradients from Environment on Native American Child Health Trajectories: Toxicants, Immunomodulation, Metabolic syndromes, & Metals Exposure

了解环境对美国原住民儿童健康轨迹的风险梯度：毒物、免疫调节、代谢综合征、

• 批准号: 10745236
• 负责人: Johnnye L Lewis
• 金额: $ 448.94万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745236
• 关键词: Address; Affect; Agreement; Birth; Categories; Characteristics; Child; Child Development; Child Health; Clinical; Cohort Studies; Conceptions; Couples; Data; Data Set; Development; Diagnosis; Disease; Education; Elements; Ensure; Environment; Environmental Exposure; Evaluation; Exposure to; Family; Fertility; Health; Income; Indigenous; Language; Language Development; Learning; Life; Life Experience; Long COVID; Measures; Metabolic syndrome; Metal exposure; Metals; Minority Groups; Modeling; Native Americans; Native-Born; Navajo; Nutrient; Nutritional; Outcome; Outcome Measure; Parents; Participant; Patient Recruitments; Population; Population Study; Pregnancy; Prospective, cohort study; Protocols documentation; Recontacts; Reporting; Research; Risk; SARS-CoV-2 infection; Screening procedure; Source; Specific qualifier value; Time; Tribes; Update; Validity and Reliability; cohort; coronavirus disease; data sharing; experience; immunoregulation; innovation; instrument; interest; neurodevelopment; offspring; pandemic disease; participant enrollment; predictive modeling; programs; recruit; resilience; response; rurality; social communication; social determinants; sociodemographics; toxicant

SUMMARY The Navajo Birth Cohort Study (NBCS) is the first large-scale, well characterized prospective cohort study to assess the relationships between environmental exposures, birth outcomes, and child development in a tribal population. Representation of the Navajo population in the National ECHO cohort will contribute significantly to the understanding of risks to Indigenous populations through comparison of exposures and outcomes with other Indigenous populations and minority populations in ECHO, enhancing the understanding of the contributions of cultures with respect to both similarities and differences. Through participation in ECHO, the NBCS will build on the unique combination of characteristics to understand contributions of sociodemographic, nutritional, cultural, and exposure variables to health outcomes as well as to positive child health. We will ask research questions that take advantage of the size and diversity of the broader ECHO Cohorts to address key questions about how variables such as income, education, and rurality combine with exposure variables to contribute to health outcomes, including resiliency. We will assess language development, learning, social communication, and neurodevelopmental diagnosis over time to understand developmental trajectories and to ask how early-life experiences and exposures assessed through ECHO may influence these trajectories. We also ask questions about how the COVID-19 infection and the pandemic may have affected developmental trajectories, including potential long-covid effects. Over the course of the next 7 years in ECHO Cycle 2, we propose to contribute data on a cumulative total of 5300 participants, inclusive of pregnancies, offspring, conceiving partners, and current participants reconsented into the updated protocol. Our recruiting team has a deep understanding of the culture and life circumstances that exist for our study participants and employ multiple strategies to overcome existing barriers to participant recruitment, reconsent and retention. We propose to recruit a minimum of 30 couples per year into the preconception pilot to address how exposures during preconception to mixed metals or other toxicants of interest across ECHO, affect fertility, birth outcomes and developmental trajectories of offspring. Inclusion of NBCS in ECHO provides an opportunity to assess child health in a tribal population with diverse cultural practices and sociodemographics who experience significant exposures to toxicants. ECHO is one of the only sources where inclusion, even at a population- representative percentage, will allow for evaluation of child development relative to the US population overall. NBCS contributes to the diversity of ECHO through inclusion of a group traditionally underrepresented in population studies of this magnitude, yet adversely affected by exposures in all categories specified in ECHO, with outcomes of clinical concern in all key outcomes addressed through the ECHO core elements.

概括 纳瓦霍出生队列研究 (NBCS) 是第一个大规模、特征明确的前瞻性队列研究 评估部落环境暴露、出生结果和儿童发育之间的关系 人口。纳瓦霍人口在国家 ECHO 队列中的代表性将大大有助于 通过比较暴露和结果来了解土著居民面临的风险 ECHO 中的其他原住民和少数民族人口，增强对 文化在相似性和差异性方面的贡献。通过参与 ECHO， NBCS 将建立在独特的特征组合的基础上，以了解社会人口统计、 营养、文化和接触变量对健康结果以及积极的儿童健康的影响。我们会问 利用更广泛的 ECHO 队列的规模和多样性来解决关键问题的研究问题 关于收入、教育和乡村等变量如何与暴露变量相结合的问题 有助于健康成果，包括复原力。我们将评估语言发展、学习、社交 随着时间的推移进行沟通和神经发育诊断，以了解发育轨迹并 询问通过 ECHO 评估的早期生活经历和暴露可能如何影响这些轨迹。我们 还询问有关 COVID-19 感染和大流行如何影响发育的问题 轨迹，包括潜在的长期新冠效应。在 ECHO Cycle 2 的接下来 7 年里，我们 建议提供累计 5300 名参与者的数据，包括怀孕、后代、 孕育伙伴和当前参与者重新同意更新的协议。我们的招聘团队有 深入了解我们的研究参与者所存在的文化和生活环境，并雇用 采取多种策略来克服参与者招募、重新同意和保留方面的现有障碍。我们 建议每年招募至少 30 对夫妇参加孕前试点，以解决暴露问题 在受孕前对 ECHO 中的混合金属或其他感兴趣的有毒物质，影响生育力、出生结果 以及后代的发育轨迹。将 NBCS 纳入 ECHO 提供了评估的机会 具有不同文化习俗和社会人口特征的部落人口的儿童健康状况 大量接触有毒物质。 ECHO 是唯一一个包容性的来源之一，即使是在一个人群中—— 代表性百分比，将有助于评估儿童相对于美国总体人口的发展。 NBCS 通过纳入传统上在 ECHO 中代表性不足的群体，为 ECHO 的多样性做出了贡献 如此大规模的人口研究，但受到 ECHO 中指定的所有类别暴露的不利影响， 通过 ECHO 核心要素解决的所有关键结果中都包含临床关注的结果。