Early Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO)

早期生活压力和疾病的环境根源：基于人群的农村贫困儿童前瞻性纵向研究 (ECHO)

• 批准号: 10013297
• 负责人: Clancy B Blair
• 金额: $ 478.47万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10013297
• 关键词: 3 year old; Achievement; Address; Adolescence; Affect; African American; Age; Anthropometry; Area; Attention deficit hyperactivity disorder; Behavioral; Biological; Biological Assay; Birth; Blood; Cardiovascular system; Caregivers; Caring; Censuses; Characteristics; Chemical Exposure; Chemicals; Child; Child Health; Child Rearing; Clinic Visits; Collection; Cotinine; County; Data; Data Analyses; Data Collection; Development; Disease; Elements; Ensure; Environmental Exposure; Ethnic Origin; Evaluation; Exposure to; Family; Future; Gender; Genes; Genetic; Genomics; Geographic Locations; Growth; Health; High Prevalence; Home environment; Hydrocortisone; Immune system; Immunologic Markers; Individual Differences; Inflammatory; Informal Social Control; Investigation; Language; Lead levels; Learning Disabilities; Life; Life Experience; Link; Longitudinal Studies; Longitudinal cohort; Longitudinal prospective study; Low income; Measures; Mediating; Mediation; Mental Health; Methods; Neighborhoods; Neuraxis; Neurotransmitters; North Carolina; Obesity; Outcome; Participant; Patient Outcomes Assessments; Pennsylvania; Phase; Phenotype; Population; Poverty; Preventive Intervention; Process; Prospective cohort; Protocols documentation; Race; Resources; Risk; Rural; Rural Health; Rural Population; Saliva; Salivary; Sampling; Schools; Testing; Time; Tobacco smoke; Urine; Visit; allostatic load; alpha-amylase; attentional control; biological adaptation to stress; blood lead; cognitive testing; cohort; data management; design; early childhood; early life exposure; early life stress; emotion regulation; environmental chemical; epigenomics; executive function; experience; feeding; follow-up; health disparity; health record; high risk; innovation; metabolomics; middle childhood; negative affect; neurodevelopment; novel; nutrition; obesity biomarkers; obesity risk; pediatric health outcomes; peer; physical conditioning; pollutant; population based; primary caregiver; prospective; psychologic; psychosocial; public health relevance; rural poverty; stressor; success; toxicant

Project Summary/ Abstract The inverse association between SES and health is well established. Its underlying causes are not. This application leverages and extends an active prospective longitudinal cohort of children and families in rural poverty to test key hypotheses about the ways in which early psychosocial and chemical exposures (0-5yrs) adversely affect pediatric health outcomes in the areas of neurodevelopment and obesity. We describe an ongoing population-based longitudinal study, the Family Life Project (FLP) with N=1292 children and their primary and when available, secondary caregivers, followed from birth and oversampled for poverty and African American ethnicity in predominantly low-income, non-urban counties in Pennsylvania and in North Carolina. Participants were seen at 8 time points birth to 5 years and at 6 time points 7 to 13 years. A primary focus of data collection and analysis has been the prospective investigation of associations between psychosocial early life stress and neurodevelopment in the areas of executive function, emotion regulation, tolerance for delay, language, school achievement, ADHD and LD. This application builds on and extends our prior data collection retrospectively and prospectively in order to amplify and enhance our focus on adverse exposures in relation to neurodevelopment and obesity risk. In the UG3 retrospective phase we expand our investigation of chemical and neighborhood level exposures when study children were 0 to 5yrs. In the UH3 prospective phase we propose data collection during two clinic visits when children are 16 and 18yrs. These visits will include the collection of all ECHO core elements plus biospecimens (blood, saliva, urine). With these data we will develop clearly defined neurodevelopment and obesity phenotypes and test our primary hypotheses linking early exposures to later health outcomes. We hypothesize direct effects of chemical and psychosocial exposures on our phenotypes as well as mediation of exposures through effects of allostatic load on the development of the central nervous system and the inflammatory processes of the immune system. Importantly, follow-up of the FLP sample into late adolescence will provide much needed information with which to reduce health disparities in high-risk, understudied rural populations. This follow-up will provide data to address key questions about the rural context and individual differences relating to race, gender, and geographic location that moderate relations between early exposures and later health outcomes. The FLP will make a unique and valued contribution to the ECHO synthetic cohort. Inclusion of the FLP will allow for the identification of factors that relate mechanistically to rural health outcomes and that can serve as the focus of prevention and intervention efforts.

项目概要/摘要 SES 与健康之间的负相关关系已得到充分证实。其根本原因并非如此。这 应用程序利用并扩展了农村儿童和家庭的积极前瞻性纵向队列 贫困测试关于早期心理社会和化学暴露（0-5岁）方式的关键假设 对神经发育和肥胖领域的儿科健康结果产生不利影响。我们描述一个 正在进行的基于人群的纵向研究，家庭生活项目（FLP），涉及 N=1292 名儿童及其 主要照顾者和次要照顾者（如果有的话）从出生起就进行跟踪，并针对贫困和贫困情况进行过抽样 宾夕法尼亚州和北部主要低收入非城市县的非裔美国人 卡罗莱纳.参与者在出生至 5 岁的 8 个时间点和 7 至 13 岁的 6 个时间点进行观察。初级 数据收集和分析的重点是对之间的关​​联进行前瞻性调查 早期生活心理压力和执行功能、情绪调节、 对延误、语言、学业成绩、注意力缺陷多动症和智力障碍的容忍度。该应用程序构建并扩展了我们的 之前的数据收集是回顾性和前瞻性的，以扩大和加强我们对不良反应的关注 与神经发育和肥胖风险相关的暴露。在 UG3 回顾阶段，我们扩展了我们的 调查研究儿童 0 至 5 岁时的化学品和社区水平暴露情况。在UH3中 在前瞻性阶段，我们建议在儿童 16 岁和 18 岁时两次就诊期间收集数据。这些 访问将包括收集所有 ECHO 核心元素以及生物样本（血液、唾液、尿液）。有了这些 根据数据，我们将开发明确定义的神经发育和肥胖表型，并测试我们的主要 将早期暴露与后期健康结果联系起来的假设。我们假设化学和 社会心理暴露对我们表型的影响以及通过调节负荷的影响来调节暴露 关于中枢神经系统的发育和免疫系统的炎症过程。 重要的是，对青春期后期 FLP 样本的跟踪将提供急需的信息 旨在减少高风险、研究不足的农村人口的健康差距。本次后续将提供数据 解决有关农村环境和种族、性别和个人差异的关键问题 地理位置调节早期暴露与后期健康结果之间的关系。 FLP 将 为 ECHO 合成队列做出独特且有价值的贡献。 FLP 的纳入将允许 确定与农村健康结果机械相关并可作为重点的因素 预防和干预工作。