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 Navajo出生队列研究（NBC）是第一个大规模的，具有良好特征的前瞻性队列研究 评估部落中环境暴露，出生成果和儿童发展之间的关系 人口。纳瓦霍人在国家回声队列中的代表将大大贡献 通过比较暴露和结果与土著人口的风险理解 回声中的其他土著人口和少数群体，增强了对 关于相似性和差异的文化的贡献。通过参与Echo， NBC将基于特征的独特组合，以了解社会人口统计学的贡献， 营养，文化和暴露变量对健康成果以及对儿童健康的积极变量。我们会问的 利用更广泛的回声队列的规模和多样性来解决关键的研究问题 关于收入，教育和农业诸如诸如收入，教育和乡村的变量如何结合暴露变量的问题 促进包括弹性在内的健康结果。我们将评估语言发展，学习，社会 随着时间的流逝，沟通和神经发育诊断，以了解发展轨迹和 询问通过Echo评估的早期经验和暴露如何影响这些轨迹。我们 还会询问有关COVID-19的感染和大流行如何影响发育的问题 轨迹，包括潜在的长卵巢效应。在Echo Cyper 2的接下来的7年中，我们 建议贡献有关5300名参与者的累积数据，包括怀孕，后代， 构想合作伙伴，当前参与者重新置于更新的协议中。我们的招聘团队有一个 对我们的研究参与者存在的文化和生活环境的深刻了解并采用 克服参与者招募，重新保留和保留的现有障碍的多种策略。我们 提议每年至少招募30对夫妇进入先入为主的飞行员，以解决如何暴露 在对混合金属或其他感兴趣的其他有毒物质的先入期间，会影响生育能力，出生结果 和后代的发展轨迹。将NBC纳入ECHO提供了评估的机会 具有多种文化实践和社会数字学的部落人口的儿童健康经验 对有毒物质的大量暴露。 Echo是包含，即使在人口中的唯一来源之一 代表性的百分比将允许评估儿童发展相对于美国总体总体的评估。 NBC通过传统上代表性不足的群体而促进回声的多样性 人口研究对大规模的研究，但受到Echo中指定的所有类别的暴露的不利影响， 通过回声核心元素解决的所有关键结果的临床关注结果。