Inequities in Childhood Life-Course Lead Exposure and Academic and Neurobehavioral Outcomes (I-CLEAN)

童年生命历程铅暴露以及学业和神经行为结果的不平等（I-CLEAN）

• 批准号: 10660566
• 负责人: Patricia Flores
• 金额: $ 60.11万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-09 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10660566
• 关键词: 10 year old; Address; Affect; Age; Age Months; Aggressive behavior; Attention; Awareness; Behavior; Binding; Biological Markers; Black race; Blood; California; Censuses; Child; Child Behavior; Child Behavior Checklist; Child Development; Child Health; Child Support; Childhood; Chronic; Cities; Cognitive; Communities; County; Data; Data Collection; Depressed mood; Development Plans; Eligibility Determination; Enrollment; Environment; Environmental Health; Equity; Etiology; Evidence based practice; Exposure to; Family; Fostering; Funding; Goals; Government; Health; Health Insurance; Household; Immigrant; Income; Individual; Industrialization; Inequity; Information Dissemination; Insurance; Intervention; Joints; Knowledge; Latina; Lead; Lead levels; Leadership; Legal system; Life; Life Cycle Stages; Link; Low income; Mathematics; Measurement; Measures; Metals; Modification; Neighborhoods; Neurologic; Neurotoxins; Oranges; Outcome; Outcome Measure; Outcome Study; Patient Recruitments; Performance; Policies; Population; Predisposition; Pregnancy; Prevalence; Prevention program; Process; Prospective cohort; Public Health; Questionnaires; Reading; Research; Resolution; Risk Factors; Schools; Science; Second Pregnancy Trimester; Series; Shapes; Soil; Source; Standardization; Strategic Planning; Symptoms; Syndrome; Time; Tooth structure; Translating; Universities; anxious; behavioral outcome; blood lead; childhood nervous system lead poisoning; chronic Pb exposure; community based participatory research; community organizations; contextual factors; deciduous tooth; design; eighth grade; elementary school; evidence base; health equity; health inequalities; implementation science; improved; kindergarten; lead exposure; neighborhood disadvantage; neurobehavioral; prevent; primary caregiver; remediation; response; screening; social; sociodemographic factors; socioeconomic disadvantage; soil lead; soil sampling; study population

Santa Ana in Orange County (OC), California (CA) is a predominantly Latina/o, immigrant and low-income community that is bound by multiple freeways, has a large industrial corridor, and has 65% of houses built prior to 1960. Residents of Santa Ana have identified lead (Pb) exposure in the community as a major environmental health concern. Responding to the concerns, we established the ¡Plo-NO! Santa Ana! (Lead-Free Santa Ana!) community-based participatory research partnership to examine elevated Pb levels in urban soil in Santa Ana since 2017. In this study, we propose to address the community-identified concerns of lead exposure and its impact on children’s health and academic performance using a community-based participatory research (CBPR) approach. We will also address important gaps in previous Pb research and practice, including 1) limited consideration of both life course exposure and susceptible time window for chronic low- level Pb exposure; 2) lack of research based on repeated outcome measures; 3) few studies on synergistic effect of metal mixtures; 4) few studies on multi-level (e.g. household, school, neighborhood) intervention; and 5) lack of community- driven research devoted to translating knowledge to effective public health equity strategies. Our overarching goal is to examine associations of life course and current Pb exposures with children’s academic performance and neurobehavioral outcomes, identify risk factors of current Pb exposure, and develop and implement a Public Health Equity Action Plan (PHEAP), with particular attention to health equity. Study population involves 600 children 7-10 years old at enrollment and their primary caregiver. Individual-level exposure to Pb and other metals will be estimated from 1) deciduous tooth-based exposure at a weekly resolution from the 2nd trimester of gestation up to the 1st year of life and every 6-months from age 1 up to the time when the tooth is shed; 2) blood for current exposure. Repeated outcomes include 5 years of academic performance and 3 years of behavior outcomes based on validated Child Behavior Checklist (CBCL) questionnaire. We will examine associations of academic performance and behavioral outcomes with deciduous teeth-based early life Pb exposure (Aim 1) and current blood Pb exposure (Aim 2). Further, we will develop, disseminate, implement, and evaluate a multi-level (e.g. household, school, neighborhood, city, county) Public Health Equity Action Plan, with a focus on equity (Aim 3). The strengths of this study include: bridging CBPR and implementation science by leveraging results from Aims 1-2 of this study and practice-based evidence to inform the PHEAP, responsiveness to community-driven priorities, strong community and university leadership, life course measurements of Pb and metal mixtures, a large prospective cohort with longitudinal measurements of both exposure and outcomes, and multiple levels of assessments (i.e. household, school, neighborhood) that advance the science on environmental health inequities to develop, evaluate, and pilot action plans and community-driven interventions. We will advance knowledge on how low levels of Pb exposure over the life course adversely affect children’s school performance and behavioral outcomes. The translational value of this study is noteworthy, as it integrates etiologic data and practice-based evidence to an equity- oriented multi-level action strategy to improve child academic and neurodevelopmental outcomes.

加利福尼亚州 (CA) 奥兰治县 (OC) 的圣安娜 (Santa Ana) 是一个以拉丁裔、移民和低收入群体为主的社区 该地区毗邻多条高速公路，拥有大型工业走廊，65% 的房屋建于 1960 年之前。 圣安娜已将社区中的铅 (Pb) 暴露确定为主要的环境健康问题。 的担忧，我们建立了¡ Plo-NO！圣安娜！（无铅圣安娜！）基于社区的参与性研究 自 2017 年以来，我们与圣安娜建立了合作伙伴关系，以提高对圣安娜城市土壤中铅含量的检测。在这项研究中，我们建议解决 社区对铅暴露及其对儿童健康和学业成绩影响的担忧 我们还将解决以前的铅研究中的重要差距。 和实践，包括 1) 对慢性低危人群的生命历程暴露和易感时间窗口的有限考虑 铅暴露水平；2）缺乏基于重复结果测量的研究；3）关于金属协同效应的研究很少； 4）关于多层次（例如家庭、学校、社区）干预的研究很少；5）缺乏社区干预； 我们的首要目标是致力于将知识转化为有效的公共卫生公平战略。 检查生命历程和当前铅暴露与儿童学业成绩和神经行为的关联 结果，确定当前铅暴露的风险因素，并制定和实施公共卫生公平行动计划 (PHEAP)，特别关注健康公平性，研究对象包括 600 名 7-10 岁儿童。 入学人数及其主要护理人员对铅和其他金属的个人接触水平将根据 1) 进行估算。 从妊娠第二个月到出生第一年，每周进行基于乳牙的暴露，并且 从 1 岁到牙齿脱落时每 6 个月一次；2) 当前暴露的血液。 包括基于经过验证的儿童行为清单的 5 年学业成绩和 3 年行为结果 （CBCL）调查问卷。我们将检查学业成绩和行为结果与乳牙的关联。 基于牙齿的早期生命铅暴露（目标 1）和当前血液铅暴露（目标 2）。 实施和评估多层次（例如家庭、学校、社区、市、县）公共卫生公平行动 计划，重点关注公平（目标 3） 本研究的优势包括：通过连接 CBPR 和实施科学。 利用本研究目标 1-2 的结果和基于实践的证据为 PHEAP 提供信息， 社区驱动的优先事项、强有力的社区和大学领导、铅和金属的生命过程测量 混合物，一个大型前瞻性队列，对暴露和结果进行纵向测量，以及多个水平 促进环境健康不平等科学发展的评估（即家庭、学校、社区） 我们将制定、评估和试点行动计划和社区驱动的干预措施。 生命历程中的铅暴露水平会对儿童的学校表现和行为结果产生不利影响。 这项研究的转化价值值得注意，因为它将病因学数据和基于实践的证据整合到一个公平的研究中 面向多层次的行动策略，以改善儿童的学业和神经发育成果。