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Your Environment. Your Health.

Environmental Influences on Child Health Outcomes (ECHO)

Program Description

The Environmental influences on Child Health Outcomes (ECHO) program will study how environmental factors affect child health and development via a new seven-year initiative from the National Institutes of Health (NIH). NIEHS, as part of NIH, is bringing extensive scientific expertise in children's environmental health to this effort.

From the Former NIH Director

"Every baby should have the best opportunity to remain healthy and thrive throughout childhood," said former NIH Director Francis S. Collins, M.D., Ph.D. "ECHO will help us better understand the factors that contribute to optimal health in children."

For ECHO, environmental exposures will include many factors, ranging from air pollution and chemicals in our neighborhoods, to societal factors such as stress, to individual behaviors like sleep and diet. The timing of environmental exposures is also important – prior research has shown that exposures during crucial developmental windows, including conception, later in pregnancy, infancy, and early childhood, can have long lasting effects on the health of children.

ECHO will focus on how environmental factors may affect health outcomes around the time of birth as well as later in childhood or adolescence. These outcomes have a substantial public health impact and include:

  • Obesity
  • Upper and lower airway conditions, including asthma
  • Neurodevelopment, or the development of the brain and nervous system

ECHO's structure

To maximize current resources, ECHO will build on existing studies that are following the health of children over time, called cohort studies. Some of these cohort studies are already assessing the health effects of environmental factors, while others are adding environmental factors because of ECHO.

ECHO will consist of more than 35 cohort studies from around the United States. All of the cohorts will measure common elements such as demographics, environmental factors, genetic influences, indicators of typical early health and development, and patient reported outcomes (PROs) that capture the voice and experience of participating children and their families. A central coordinating center will manage and standardize the contributions from the individual studies, and a data analysis center will provide support for statistical analysis.

ECHO will also leverage resources from NIH-funded institutions that are part of the Institutional Development Awards (IDeA) Program to build an IDeA States Pediatric Clinical Trials Network (ISPCTN). The goal of the ISPCTN is to provide access to state-of-the-art clinical trials for medically underserved and rural populations. Study results from relevant pediatric cohort studies will also be shared with clinicians in IDeA state locations. There will also be a Data Coordinating and Operations Center for ISPCTN.

What NIEHS is doing

Three scientists from NIEHS, David Balshaw, Claudia Thompson, and Kimberly Gray, have helped to plan this research as part of the ECHO working group, along with representatives from 15 other institutes, centers, and offices within the NIH Office of the Director.

NIEHS is also leading the Children's Health Exposure Analysis Resource (CHEAR). CHEAR will provide ECHO-supported researchers, and other NIH-funded scientists, with laboratory testing and statistical consultation to aid the inclusion of environmental factors in studies of children's health. CHEAR will begin accepting applications from NIH-funded scientists on September 30, 2016.

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