National Children's Study
InTouch Winter 2008 (Volume 4: Issue 4)
Jane Holl, MD, MPH, attending physician and Medical Director for Patient Safety at Children’s Memorial Hospital, and Associate Professor of Pediatrics, Preventive Medicine, and Healthcare Studies at Northwestern University's Feinberg School of Medicine, is the principal investigator for the Chicago area’s involvement in the largest child health study to be conducted in U.S. history. The study will follow women from pre-pregnancy through conception and childbirth, and then track their children until age 21.
In the year 2000, the Children’s Health Act was passed in the United States Congress. The legislation included a recommendation for the development of what became the National Children’s Study — a national, longitudinal study about the health of U.S. children. The National Institute of Child Health and Human Development brought together representatives from the Environmental Protection Agency, the Centers for Disease Control and Prevention and all the other NIH branches to start planning the design, methodology, sampling, hypotheses and goals. Seven pilot, or vanguard, sites were selected in 2005 to test various aspects of the study, including the sampling strategy, community engagement and community outreach, and sample collection. The vanguard sites are slated to begin data collection in July of 2008.
In early 2007, a Request for Applications (RFA) was put out for study centers, to which Northwestern responded. Holl noted: “As a general pediatrician who for many years had been conducting health services research, looking at topics such as access to care, health insurance coverage for children, the relationship between health insurance coverage and adequate health care services, and patient safety and medical errors, I understood the incredible value of longitudinal data sets.”
When the RFA came out, “I realized we had a great opportunity. At the time I had been collaborating closely with a number of maternal-fetal medicine obstetricians at Northwestern. The study is of great interest to obstetricians because the amount of data gathered during pregnancy, and the outcomes of all the infants, is unprecedented.”
“We realized early on that we would strengthen our application if we could come in with a single bid from all the major academic medical institutions in the Chicago area.” The contract was awarded to Northwestern and will be based at the Institute for Healthcare Studies. There are three key partners with co-investigators at the University of Chicago, the University of Illinois at Chicago, particularly in the School of Public Health, and the National Opinion Research Center (NORC). NORC will be conducting a large part of the field work, in particular the community-based screening, recruitment and enrollment of study subjects. “We have capitalized on some of the main strengths of each of our institutions through the inclusion of co-investigators with specific expertise that is critical to the success of the study,” Holl said.
The National Children’s Study will examine the effects of environmental influences on the health and development of more than 100,000 children across the United States, with the ultimate goal to improve the health and well-being of children. The study defines “environment” broadly, including: natural and man-made environment; biological and chemical; physical surroundings; social and behavioral; genetics; cultural and family; and geographic locations. By analyzing how these elements interact and what their effects might be on children’s health, researchers hope to gain an understanding of the roles of these factors on health and disease.
As Holl noted: “A wide range of data will be collected. There will be a series of self-reported survey measures, all kinds of demographic information, information about family composition, and the environment in which the child is growing up. There’s a huge environmental health component with virtually all types of environmental samples being obtained at many points during pre-conception, pregnancy, and throughout the child’s life, such as air, water and soil. We’ll be able to comment on the community environmental measures and exposures for these children. There will also be a wide array of biological samples collected. For example, during pregnancy the mother will receive three ultrasounds although this is not at all typical for a routine pregnancy. Numerous biomarkers will be obtained during pregnancy and after the children are born.”
The study will also allow scientists to address disparities that exist between different groups of children in terms of their health, health care access, disease occurrence and quality of care. Because many questions will arise that cannot be investigated by the primary study centers, adjunct studies will be encouraged to answer these more specific or local questions.
Holl expects to begin recruiting families in the summer of 2009. The National Children’s Study will provide an incredibly rich source of information to answer questions related to children’s health and development, and will form the basis of child health guidance, interventions and child health policy for years to come.
Information in this article about the National Children’s Study is from: “What is the National Children’s Study?” at www.nationalchildrensstudy.gov/about/mission/overview.cfm.
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