‘Current Opinion in Pediatrics’ Publishes Seven Manuscripts from ECHO Program

The April 2018 issue of Current Opinion in Pediatrics features seven manuscripts authored by and about the Environmental influences on Child Health Outcomes (ECHO) research program, supported by the National Institutes of Health. Readers can find each of the manuscripts, one from each active ECHO Program Component, in the journal’s “Therapeutics and Toxicology” section. Together, they offer readers a glimpse into ECHO’s mission and progress from diverse vantage points.

Current Opinion in Pediatrics gives us a forum to showcase how each of ECHO’s Components is working collectively toward the ECHO mission to enhance the health of children for generations to come,” said Matthew Gillman, ECHO program director, National Institutes of Health. “We developed ECHO on the premise that the whole is greater than the sum of its parts. That premise applies equally to the ECHO Cohorts and the IDeA States Pediatric Clinical Trials Network. Their combined intellectual capital, disciplines, innovation, and analyses will bring us closer to our mission than individual cohorts or clinical trial sites could ever reach alone. I am inspired by the work across all ECHO Components to bring this premise to life.”

Current Opinion in Pediatrics is a great platform for ECHO. As a publication that spans all the subspecialties and primary care, it represents a product that is more than the sum of its parts, just like ECHO,” said Robert Wright, the publication’s editor. “It is critical for the pediatric health care community to learn about ECHO and the exciting work that will one day change the way pediatrics is practiced.”

Readers can access all seven articles electronically in the journal’s April 2018 (volume 30, issue 2) publication or via the links below:


NIH Releases Report Summary of ECHO-wide Cohort Data Collection Protocol Request for Information (RFI) Responses

On August 11th, 2017 the NIH published an RFI seeking feedback from stakeholders and the general public on the ECHO-wide Cohort Data Collection Protocol. The RFI specifically requested feedback and recommendations on the data element concepts, types of biospecimens, and innovative data collection methodology. The NIH received a number of responses from researchers, professional organizations, nonprofit organizations, and research foundations. View the responses to this RFI here. The NIH thanks all responders for their input.

NIH-Funded Study to Focus on Newborns Affected by Opioids


Experts plan clinical trial to test treatments for withdrawal syndrome.

The National Institutes of Health is funding a new study to evaluate treatment options for newborns with opioid withdrawal syndrome, a condition caused by exposure to opioids during pregnancy. Currently, health care providers in the United States lack standard, evidence-based treatments for neonatal opioid withdrawal syndrome, despite states reporting more cases in recent years. The study, called Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW), aims to inform clinical care of these infants.

ACT NOW is funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the NIH Office of the Director’s Environmental Influences on Child Health Outcomes (ECHO) Program.

Opioids are a class of drugs commonly prescribed for pain relief. Prescriptions for these drugs have quadrupled since 1999 in the United States, putting more reproductive-age women at risk of developing opioid use disorder. Use of these drugs during pregnancy can affect the health and well-being of women and lead to withdrawal symptoms in newborns. Symptoms often include tremors, excessive crying, sleep deprivation and swallowing difficulties.

Read the full press release here to learn more about this study. 



The NIH Invites Comments on the ECHO-wide Cohort Data Collection Protocol

On August 10, 2017, the National Institutes of Health (NIH) released a Request for Information (RFI) to solicit input from a wide variety of stakeholders on the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Data Collection Protocol. Stakeholders that the NIH hopes will respond to the RFI include: non-ECHO researchers, advocacy groups, professional organizations, and the general public. Comments are due by September 13, 2017. For more information and to contribute, please visit: https://grants.nih.gov/grants/guide/notice-files/NOT-OD-17-090.html.


Environmental influences on Child Health Outcomes (ECHO) is a nationwide NIH-funded research program whose mission is to enhance the health of children for generations to come. The program consists of observational and intervention components. This RFI pertains to the observational component, the ECHO Pediatric Cohorts. The overall scientific goal of the ECHO Pediatric Cohorts is to investigate associations of a broad array of early environmental influences with child health and development. ECHO prioritizes addressing research questions that have impact on policies, practices, and programs.

ECHO’s Early Progress and Plans to Enhance Child Health in 2017 & Beyond

As we begin 2017, I reflect on the promising strides ECHO has made and look forward to successes in 2017 and beyond. In November 2016, we kicked off ECHO in a big way. Bringing together all of ECHO’s Components under one roof, we hit the scientific ground running and began to foster the culture of collaboration that is vital to ECHO’s success. We witnessed ECHO’s investigators taking leadership positions in our Working Groups.  We observed rapid progress when these investigators collaborated in small groups and shared what they learned in larger group discussion.

Most importantly, we rallied around ECHO’s core mission: “to enhance the health of children for generations to come.” This mission speaks to all parts of ECHO: the observational studies of our Cohorts, the interventional studies within the IDeA States Pediatric Clinical Trials Network, and the Centers and Cores — including the Children’s Health and Exposure Analysis Resource (CHEAR) Core, the Patient Reported Outcomes (PRO) Core, the Data Analysis Center (DAC), and our ECHO Coordinating Center (CC) — that support this research.

ECHO’s long-term goals are both scientific and strategic. From a scientific perspective, our goal is to improve the health of children and adolescents by conducting solution-oriented research that informs high-impact programs, policies, and practices. From a strategic perspective, we aim to institute best practices for how to conduct Team Science in the 21st century. We’ve set an ambitious agenda for our first year, which includes 1) achieving early scientific wins by capitalizing on one of ECHO’s most powerful features: the extant data of its existing Cohorts, and 2) crafting a robust infrastructure for the IDeA States Pediatric Clinical Trials Network to begin initiating trials in our second year.

I am thrilled with the progress we have made, but ECHO’s most exciting days will be in 2017 and beyond. ECHO is underpinned by the fundamental notion that when we all row in the same direction, the whole is greater than the sum of our parts. For ECHO’s Cohorts, this means knitting a tapestry of the ECHO-wide Cohort and harmonizing its extant data. For CHEAR Core, PRO Core, and the DAC, it means analyzing existing and new insights and standardizing data collection. On the interventional side, the IDeA States Network is endeavoring to prioritize trials that examine focus areas that are similar to the Cohorts’:  pre-, peri- and postnatal health, childhood obesity, airways disorders, and neurodevelopment.

As we continue to bring ECHO to life in 2017, we will begin to address questions that link a broad range of early environmental influences to the health of a highly diverse population of children and adolescents. We are eager to begin this journey to move the needle in improving child health.

Matthew W. Gillman, MD, SM




ECHO Kickoff Highlights Team Science and Innovative Research

On November 9th and 10th, nearly 200 outstanding scientists came together to launch the Environmental influences on Child Health Outcomes (ECHO) program—and it was a major success. Attendees felt genuine enthusiasm to be part of ECHO’s mission to enhance the health of our nation’s children, guided by the principles of teamwork, impact, responsibility, and value.

During his presentation, NIH Director Francis S. Collins, M.D., Ph.D., emphasized the special place for ECHO in the long history of NIH-sponsored, population-based, observational cohort and intervention research.  Large sample sizes and new technologies are allowing us to zero in on answers to solution-oriented research questions in ways that were not possible just a few years ago.

I am so grateful for the engagement and productivity that I witnessed coming out of the working groups that we initiated at the Kickoff Meeting.  Half of the groups started developing scientific hypotheses that ECHO Cohorts can achieve with existing data, even within our first year.  These hypotheses prioritized the five ECHO focus areas:  pre- and perinatal outcomes, child obesity, airways, neurodevelopment, and positive health outcomes.

The other half of the working groups focused on policies and practices—for data sharing, harmonization, and analysis; use of biospecimens; publications; and engagement—that we envision will drive best practices for conducting team science in the 21stcentury.

One of the most inspiring aspects of the meeting was the contributions of all six funded components of ECHO. In addition to the Cohorts, they include the IDeA States Pediatric Clinical Trials Network, the Children’s Health and Exposure Analysis Resource (CHEAR) Core, the Patient-Reported Outcomes Core, the Data Analysis Center, and the Coordinating Center. Altogether they comprise 110 principal investigators and their institutions from more than 40 states, Puerto Rico, and the District of Columbia. These investigators, with my colleagues from across the NIH institutes, centers, and offices, will be instrumental in leading ECHO to achieve its long-term vision of becoming a pre-eminent research program in child health.

I encourage you to learn more about the goals of ECHO and watch highlights of the meeting here: https://youtu.be/Q2c1ncanSdI(link is external).

Matthew W. Gillman, M.D.




Gauging Value from ECHO Stakeholders

As the director of the new NIH program, Environmental Influences on Child Health Outcomes (ECHO), I am privileged to have the opportunity to work with some of the country’s best scientists to identify, quantify, and explain how early environmental factors give rise to salient health outcomes of the pre- and perinatal period and during childhood and adolescence. My first job is underway: a listening tour to understand how the many ECHO stakeholders think the program can be most helpful to their constituencies and to society.

Concurrently, reviews of submitted grant applications are taking place. From initial peer review through awarding grants before this fiscal year ends on September 30, hundreds of individuals—from the broader scientific community as well as within NIH—are putting in extraordinary efforts to launch this complex program. We appreciate your contributions immensely!

My professional background includes, initially, working as a med-peds primary care physician in a community health center and then as an epidemiologist studying the earliest origins of health outcomes across the life course. I look forward to applying my experience, along with the complementary expertise of program staff we are now hiring, to help ECHO meet its great potential. Together with leadership from the other components of ECHO, we accept the public’s trust to shepherd ECHO to success.

Matthew W. Gillman, MD, SM