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. 2023 Jun 15:11:1171214.
doi: 10.3389/fped.2023.1171214. eCollection 2023.

Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program

Traci A Bekelman  1 , Leonardo Trasande  2 , Andrew Law  3 , Courtney K Blackwell  4 , Lisa P Jacobson  3 , Theresa M Bastain  5 , Carrie V Breton  5 , Amy J Elliott  6 , Assiamira Ferrara  7 , Margaret R Karagas  8 , Judy L Aschner  9   10 , Nicole Bornkamp  11 , Carlos A Camargo Jr  12 , Sarah S Comstock  13 , Anne L Dunlop  14 , Jody M Ganiban  15 , James E Gern  16 , Catherine J Karr  17 , Rachel S Kelly  18 , Kristen Lyall  19 , T Michael O'Shea  20 , Julie B Schweitzer  21 , Kaja Z LeWinn  22
Affiliations

Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program

Traci A Bekelman et al. Front Pediatr. .

Abstract

Objective: Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity.

Methods: ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement.

Results: This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native, <1% Native Hawaiian or Pacific Islander, 10% Multiple race and 2% Other race), Hispanic ethnicity (22% Hispanic), and were similarly distributed across the four United States Census regions and Puerto Rico.

Conclusion: ECHO data collected during the pandemic can be used to conduct solution-oriented research to inform the development of programs and policies to support child health during the pandemic and in the post-pandemic era.

Keywords: environmental exposures; health behaviors; health disparities; life course approach; parent-child dyads; pediatric health.

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Conflict of interest statement

All authors report funding from the National Institutes of Health.

Figures

Figure 1
Figure 1
Number of COVID-19 questionnaires administered to children birth to 21 years and their caregivers who participated in the ECHO-wide common protocol during the first 17 months of the COVID-19 pandemic by month of administration.
See this image and copyright information in PMC

References

    1. Larcher V, Brierley J. Children of COVID-19: pawns, pathfinders or partners? J Med Ethics. (2020) 46(8):508–9. 10.1136/medethics-2020-106465 - DOI - PMC - PubMed
    1. Minkus L, Groepler N, Drobnič S. The significance of occupations, family responsibilities, and gender for working from home: lessons from COVID-19. PLoS One. (2022) 17(6):e0266393. 10.1371/journal.pone.0266393 - DOI - PMC - PubMed
    1. Carlson DL, Petts RJ. US Parents’ domestic labor during the first year of the COVID-19 pandemic. Popul Res Policy Rev. (2022) 41(6):2393–418. 10.1007/s11113-022-09735-1 - DOI - PMC - PubMed
    1. Hedderson MM, Bekelman TA, Li M, Knapp EA, Palmore M, Dong Y, et al. Trends in screen time use among children during the COVID-19 pandemic, July 2019 through August 2021. JAMA Netw Open. (2023) 6(2):e2256157. 10.1001/jamanetworkopen.2022.56157 - DOI - PMC - PubMed
    1. Wachs TD, Georgieff M, Cusick S, McEwen BS. Issues in the timing of integrated early interventions: contributions from nutrition, neuroscience, and psychological research. Ann N Y Acad Sci. (2014) 1308:89–106. 10.1111/nyas.12314 - DOI - PMC - PubMed