ECHO has already produced several exciting publications so far this year, many of which have amassed media attention. The year is off to a great start for the ECHO Program. In the March 2024 ECHO Connector, we focus on the ways ECHO investigators are conducting important research on how maternal health, exposures, and habits influence child health. Learn about two recent research articles, one of which reports on ECHO Cohort studies of chemical exposure and the other on the benefits of early breastfeeding, in the News You Can Use section.

In the January ECHO Connector, I highlighted the public availability of de-identified ECHO data and new NIH funding opportunities for the intervention research arm of ECHO. Both are important to the future success of the ECHO Program. Here are more details:

• De-identified data from the ECHO Cohort are available to any qualified researcher through the Eunice Kennedy Shriver National Institute for Child Health and Development (NICHD) Data and Specimen Hub (DASH). This resource, containing data from over 60,000 ECHO Cohort participants, allows members of the broad scientific community to answer important research questions about the origins of child health outcomes. Learn more about this dataset and how to request access.
• The ECHO Program Office recently announced two Notices of Funding Opportunity (NOFOs) for a third 5-year cycle of the ECHO Institutional Development Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN). We also recently posted Frequently Asked Questions and prerecorded webinars regarding these opportunities. We welcome applications from entities/institutions in IDeA-eligible states to participate in the ECHO ISPCTN as either a Clinical Site or the Data Coordinating and Operations Center (DCOC). These awards will support state-of-the-art pediatric clinical trials in states with historically low rates of NIH funding. Applications are due April 15; please spread the word!

I’m glad the word is getting out about ECHO results, the fruits of efforts of hundreds of researchers and tens of thousands of participants. On behalf of the entire ECHO Program, I thank you for partnering with us to disseminate our research, which is enhancing the health of children for generations to come.

—Matthew W. Gillman, MD, SM

Happy New Year! In this first message, I highlight how the entire scientific community can use ECHO data to explore critical scientific questions in child health.

De-identified data from the ECHO Cohort are available to any qualified researcher through the Eunice Kennedy Shriver National Institute for Child Health and Development (NICHD) Data and Specimen Hub (DASH). Over 60,000 ECHO Cohort participants have generously shared their data on this platform, including information about demographics, early development, environmental exposures, pregnancy and birth, and public health crises, as well as child health outcomes. I hope that a large number of scientists will use these data for teaching and research. I think they will be particularly fruitful for researchers in training, who often look for meaningful data to answer their research questions in a relatively short period of time.

This month’s spotlight story highlights one example of the richness of ECHO Cohort data available in DASH—data on nutrition. We know from animal experiments and smaller studies of human populations that diet early in development can have long-lasting consequences. Now, longitudinal ECHO data on over 25,000 pregnancies and over 25,000 children, from 34 states, are ready for researchers to explore questions of diet and child health in a nationwide sample. You can learn more in the January ECHO Connector about the publication that describes this nutritional resource and how researchers can request access to ECHO Cohort data in DASH.

—Matthew W. Gillman, MD, SM

The end of the calendar year is a time for celebration. Today we celebrate ECHO’s many recent successes and how they showcase the principles that guide our work, and we anticipate even greater impact in 2024.

ECHO’s solution-oriented approach means that we focus our research on informing programs, policies, and practices to promote long-lasting health for our country’s children. For example, our work on child health disparities demonstrates that they may be present as early as infancy, how they widen as children grow, and, equally importantly, what may drive them in the first place. This type of research emphasizes our approach to real-world solutions, aided by collaboration with many organizations, like yours, with whom we share our commitment to enhancing child health for generations to come.

The next year holds great promise for both the observational work of the ECHO Cohort Consortium, which has just launched its second 7-year cycle, and the intervention research of the ECHO Institutional Developmental Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN). In early 2024, ECHO Cohort Study Sites will launch our new protocol that will follow over 30,000 current child participants and will enroll approximately 30,000 new pregnancies and their offspring. A novel addition is our preconception cohort that will follow several thousand women and their partners to examine how environmental factors even before pregnancy begins can affect their children.

Our investigators have published many papers in peer-reviewed journals this year, bringing our program lifetime total to more than 1500. These publications span a broad spectrum of topics across ECHO’s child health focus areas, highlighting our collaborative team approach to science. We are excited to continue producing high-impact research in the next year and beyond. Please see the ECHO publication database to explore these papers and check back often to find our most recent work.

—Matthew W. Gillman, MD, SM

I take great pleasure in sharing that the ECHO Cohort Consortium entered a new cycle at the beginning of September, which will allow the ECHO Program to extend and expand the ECHO Cohort to fulfill its mission of enhancing child health for generations to come. We look forward to continuing the high-impact research coming out of ECHO over the next seven years.

National Childhood Obesity Awareness Month this month reminds us that ECHO investigators conduct important research on how nutrition influences child health across all five ECHO outcome areas, including obesity. You can learn more in this month’s Research Spotlight story about a recent ECHO Cohort study that found limiting access to sugary drinks in the home can reduce child consumption by up to 87%, offering a possible approach to reduce childhood obesity.

Finally, I want to remind you that we have two current funding opportunities. These Notices of Funding Opportunities (NOFOs)  for postdoctoral fellows and doctoral candidates, respectively, both provide a chance to study child health outcomes by performing analysis of the ECHO Cohort’s large longitudinal data set on the Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD) Data and Specimen Hub (DASH) The knowledge and experience generated by these two opportunities will help ECHO pursue its goal of providing a national resource.

May 20 is Clinical Trials Day. This month, I’m pleased to be able to share important new findings from the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN), which helps address disparities in pediatric research by including children from rural or underserved populations in clinical trials, and by building pediatric research capacity in states with historically low NIH funding.

New ISPCTN research, titled “Eat, sleep, console approach versus usual care for neonatal opioid withdrawal,” was recently published in the New England Journal of Medicine. Researchers found that the “Eat, Sleep, Console” (ESC) care approach for treating newborns exposed to opioids during pregnancy substantially decreases the time until infants are medically ready for discharge and reduces use of opioid medications to treat these babies. Until now, there hasn’t been strong evidence to support a standard care approach for babies with neonatal opioid withdrawal syndrome (NOWS). Hospitals currently have widely different approaches. This clinical trial gives hospitals an evidence-based care approach for babies with NOWS. You can learn more about this study in the ECHO Connector Research Spotlight.

I’m also pleased to share that on March 16–17, 2023, ECHO hosted a virtual workshop on the Return of Individual Research Results to Participants to identify principles and best practices to ethically and feasibly return individual research results to participants in large-sample studies that include pregnant women and children. Over 500 registrants heard 16 expert speakers and discussants present their work on the history and principles of returning individual results, and the value of results to participants, in addition to a fruitful discussion on which results to return, and how to return individual results. More information and recordings of the presentations are available here.

March is National Nutrition Month. ECHO investigators are conducting important research on how nutrition influences child health across all five ECHO Program health outcome areas. This month’s edition of the Connector highlights recent ECHO research in this area.

The Research Spotlight features ECHO research that suggests that children’s body mass index (BMI) has decreased following implementation of the Healthy, Hunger-Free Kids Act, possibly due to increased diet quality. ECHO’s large sample size, diversity, and ability to follow kids over long periods of time means that our researchers can leverage “natural experiments”—like policy changes or the COVID-19 pandemic—to examine how they affect children.

As a reminder, ECHO, assisted by NIH partners, will host a Virtual Return of Individual Research Results Workshop March 16-17, 2023. I invite you to join us for this two-day event aimed at identifying best practices for large-sample studies of pregnancy and childhood to ethically and feasibly return individual research results to participants. More information on workshop topics and registration information is available here.

Happy New Year! Last year, the ECHO Program continued to make substantial progress in our mission to enhance the health of children for generations to come. I thank all participants and researchers involved with ECHO for their contributions in 2022 and look forward to continued success in 2023.

As a reminder, de-identified data from the ECHO Program are now available as a resource for the entire scientific community. This public-use version of ECHO-wide Cohort data fulfills both a key strategic goal of the ECHO Program and an obligation to U.S. taxpayers for their investment in our research. You can learn more about this data set and how researchers can request access to it in the January issue of the Connector.

Another announcement of potential interest: ECHO, assisted by other NIH partners, will host a workshop on Return of Individual Research Results to Participants on March 16-17, 2023. The purpose of the workshop is to identify best practices to ethically and feasibly return individual research results to participants in large-sample studies including pregnant women and children. I invite anyone interested to join the audience; click for registration details.