Families Who Had More COVID-19 Pandemic-Related Hardships Had More Stress, Lower Child Life Satisfaction

Author(s): Courtney K. Blackwell, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, with co-funding from the Office of Behavioral and Social Sciences Research (OBSSR).

Footnote: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What were the study results?

Families with more COVID-19 pandemic-related hardships had higher levels of caregiver and child stress and lower child life satisfaction. Children who had higher levels of social connection and family engagement had better life satisfaction. For younger children, family engagement also decreased the negative effect of stress on life satisfaction. For adolescents, having anxiety and/or depression was a risk factor associated with lower life satisfaction during the pandemic.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study demonstrated the different ways caregivers, children, and adolescents have coped with stress and adapted to the COVID-19 pandemic. The results of this study highlight the importance of family engagement and peer social connection in promoting children’s well-being during adverse events. This study also showed that stress and well-being are not direct opposites, suggesting the need for interventions that can both decrease children’s stress and improve their well-being.

Why was this study needed?

Families have faced many challenges during the COVID-19 pandemic, but we don’t yet know much about how these challenges have impacted children’s mental health. While negative mental health outcomes are important to research, it is just as important to understand what helps children maintain positive mental health during hard times. This study investigated how the impact of COVID-19 pandemic-related family hardships have affected child and adolescent well-being and identified factors that can improve and protect their well-being during difficult times.

Who was involved?

This study surveyed 977 caregivers of children ages 2 to 12 from 11 ECHO cohorts and 669 adolescents ages 11-17 and their caregivers from five ECHO cohorts. These participants came from 30 U.S. states.

What happened during the study?

The researchers collected survey data from May 2020 to May 2021. These surveys asked each participant about their family’s COVID-19 pandemic experience. The researchers combined data from the different cohorts to look at how pandemic-related sources of stress (also called “hardships”) were related to caregiver and child stress, and how stress, social connection, family engagement, and pre-existing mental health conditions related to children’s life satisfaction.

What happens next?

The next steps for this research include looking at which specific COVID-19 family hardships have the most impact on caregiver and child stress and well-being so that we can design more specific interventions.

Where can I learn more?

Access the full journal article, titled “Youth well-being during the COVID-19 pandemic” in Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published: March 18, 2022

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Families Who Had More COVID-19 Pandemic-Related Hardships Had More Stress, Lower Child Life Satisfaction

ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

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ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

Authors: Caitlin Howe, Margaret R. Karagas, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Researchers found that combined exposure to all metals in the mixture did not affect birth weight. Mothers with high levels of the metal antimony in their urine had smaller babies across all three of the ECHO cohorts. Two other metals – cadmium and molybdenum – had no impact on fetal growth. Findings for other metals (cobalt, mercury, nickel, tin) varied depending on the study population and whether the baby was male or female.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study used an approach that looked at multiple chemicals at once, in contrast to previous studies that have typically evaluated one chemical at a time. The findings suggest that antimony, an understudied metalloid, may harm fetal growth in different populations across the United States.

Why was this study needed?

Exposure to toxic metals can harm fetal growth (how much a baby grows during pregnancy), while nutritionally essential metals can support fetal growth. Previous research studying the effects of metals during pregnancy on fetal growth has usually focused on one metal at a time. However, most people are exposed to multiple metals, which may have complex effects on fetal growth. Therefore, combining data from three ECHO cohorts representing different geographic regions in the U.S., the research team looked at how maternal exposure to multiple metals affects fetal growth, an important indicator of future health.

Who was involved?

This study included approximately 1,000 pairs of mothers and newborns who are participating in three ECHO cohorts:

The MADRES study, a predominantly lower income Hispanic cohort in Los Angeles, California
The NHBCS, a primarily non-Hispanic white cohort in northern New England
The PROTECT study, a Hispanic cohort in northern Puerto Rico.

What happened during the study?

The research team combined data from the three cohorts to measure multiple metals in the mothers’ urine samples collected during pregnancy. They then looked at associations between seven metals and birth weight for gestational age using a multi-chemical mixture approach. Birth weight for gestational age is commonly used as a measure for fetal growth.

What happens next?

Since antimony may harm fetal growth, it is important to identify major sources of exposure to this metal so that exposure can be reduced for pregnant women. In future studies, the team would like to include more ECHO cohorts in their research, explore other indicators of metal exposures (such as placental measures of metals), and identify time periods when toxic and essential metal exposures are most harmful or beneficial for pregnant women and their children.

Where can I learn more?

The full journal article, titled “Prenatal metal(loid) mixtures and birth weight for gestational age: a pooled analysis of three cohorts participating in the ECHO Program” is published in Environment International.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published March 01, 2022

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ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

ECHO Study Suggests Link Between Smoking During Pregnancy and Autism-Related Traits in Children

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ECHO Study Suggests Link Between Smoking During Pregnancy and Autism-Related Traits in Children

Authors: Rashelle J. Musci, Irva Hertz-Picciotto, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Smoking before or during pregnancy was consistently associated with ASD traits, such as symptoms of social impairments. Additionally, babies born at full term had a somewhat higher risk of receiving an ASD diagnosis as a child if their mothers smoked before or during the pregnancy.

More counseling is needed for pregnant women or those planning a pregnancy to help them understand how these potential risks for the child’s behavioral development add to other poor outcomes associated with smoking during pregnancy, such as low birthweight, increased likelihood of fetal or infant death, asthma in early childhood, or attention deficit hyperactivity disorder (ADHD).

Footnote: Results reported here represent results from 11 or seven studies, depending on the outcome. Other or future studies may provide new information or different results. Consult your healthcare professional for guidance on how to limit your unborn child’s exposure to tobacco smoke. However, please also note that you have a greater chance of improving your child’s health and their social and behavioral development the sooner you quit or reduce smoking.

What was the study's impact?

There are many reasons for women to limit their exposure to tobacco smoke during pregnancy—tobacco smoke increases risk for low birthweight, ectopic pregnancy, a premature delivery, or fetal/infant death. Less research has been done to learn how tobacco smoke can influence children’s health, although studies have linked prenatal smoking to higher childhood asthma and ADHD risk. This study shows how prenatal exposure to cigarette smoke may also harm a child’s social development. Social skills can be important for success in school and getting along with others. Doctors, child educators, and other health and daycare providers should also know that children exposed to prenatal cigarette smoke may also be at higher risk for developing ASD.

Why was this study needed?

Previous studies provide varying results on how tobacco smoke exposure during pregnancy may affect risk for autism spectrum disorder (ASD) in children. Exposures to air pollution, which has many of the same chemicals as tobacco smoke but at lower levels, have also been linked with ASD. ASD is a complex condition that involves not only trouble in social interactions but also communication problems and patterns of repetitive behaviors or narrow interests.

The research team set out to conduct a study with participants from across the U.S. that could clear up inconsistencies found in previous research. Additionally, no other research has looked at the relationship between maternal tobacco smoking and milder autism-like symptoms of social impairment.

Who was involved?

Researchers studied approximately 11,000 children in 13 cohorts around the U.S. who either had a diagnosis of ASD, social impairment measurable on the Social Responsive Scale, or both. There also had to be information on exposure to prenatal smoking and other factors that could influence the study results.

What happened during the study?

Researchers pulled together and analyzed results from each cohort related to maternal smoking behaviors before or during pregnancy and childhood ASD diagnosis or ASD-related social impairment. The team took specific actions to prevent other factors related to the children and mothers from affecting the quality and consistency of the data.

What happens next?

Future studies can help researchers identify when babies are most at-risk to cigarette smoke exposure and how other factors associated with prenatal smoking may contribute to negative health outcomes.

Where can I learn more?

Access the full journal article, titled “Maternal Tobacco Smoking and Offspring Autism Spectrum Disorder or Traits in ECHO Cohorts” in Autism Research.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published February 24, 2022

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ECHO Study Suggests Link Between Smoking During Pregnancy and Autism-Related Traits in Children

ECHO Study Links Fast Growth During First Five Years of Life With Younger Onset of Puberty in Children

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ECHO Study Links Fast Growth During First Five Years of Life With Younger Onset of Puberty in Children

Author: Izzuddin M. Aris, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

What were the study results?

In male children, gaining weight or growing faster than their peers in the first five years of life was associated with entering puberty at a younger age. The researchers found similar results in female children, but only among those with faster weight gains during early childhood (two to five years of age). Female children with faster weight gains during infancy (six months to two years of age) and early childhood started their periods earlier and had more advanced pubic hair development.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study has a direct clinical impact. As pediatricians regularly measure weight and height during routine visits and use growth curves to identify abnormal growth predictions, they could closely monitor children who have faster weight and height gains in the first five years of life for earlier onset of puberty. These study results may also inform future studies that aim to develop and/or test interventions to potentially help prevent earlier onset of puberty, such as good nutrition, environmental exposures, physical activity, and other behaviors related to growth during the first five years of life.

Why was this study needed?

Puberty is a key stage during child development. Previous research indicates that children in the United States are entering puberty at younger ages. These children may be in danger of developing certain diseases, such as type 2 diabetes, later in life. A better understanding of how early life factors affect puberty development is important for combating earlier puberty onset.

Who was involved?

This study included almost 7,500 children from 36 birth cohorts. All participating cohorts had documented at least one measure of weight and height in the first five years of the child’s life and at least one measure of puberty development.

What happened during the study?

The researchers used participants’ weight and height data to look at the following signs of puberty: age when the child experienced the most growth due to puberty; age of their first period (in female children only); puberty development score; and pubic hair development. The team then examined how gains in weight, height, and body mass index at different stages between birth and age 5 were related to puberty development, controlling for maternal and child characteristics.

What happens next?

The team planned follow-up studies that will aim to identify the mechanisms behind these initial observations. They also aim to identify the role of puberty in explaining the relationship between early life factors and longer-term chronic diseases, such as type 2 diabetes.

Where can I learn more?

Access the full journal article, titled “Analysis of early life growth and age at pubertal onset in US children” in JAMA Network Open.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published February 4, 2022

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ECHO Study Links Fast Growth During First Five Years of Life With Younger Onset of Puberty in Children

ECHO Study Suggests Negative Associations Between Chronic Conditions and Positive Health May Be Primarily Attributed to a Co-Occurrence of Depression

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ECHO Study Suggests Negative Associations Between Chronic Conditions and Positive Health May Be Primarily Attributed to a Co-Occurrence of Depression

Author(s): Julia Schuchard, Courtney K. Blackwell, Jody M. Ganiban, Angelo P. Giardino, Monica McGrath, Phillip Sherlock, Dana M. Dabelea, Sean C. L. Deoni, Catherine Karr, Cindy T. McEvoy, Barron Patterson, Sara Santarossa, Sheela Sathyanarayana, Irene Tung, Christopher B. Forrest

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

What were the study results?

Of the 16 mental and physical health conditions included in this study, only depression showed a meaningful association with lower life satisfaction among children aged 8 to 17. Ninety-five percent of children with depression also had another chronic condition.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The study results suggest that negative associations between chronic conditions and positive health may be primarily attributed to a co-occurrence of depression. The symptoms of physical and developmental health conditions may last for years, or even a lifetime. However, interventions like regular screening for depression, particularly among children with other health conditions, could help minimize the effects these conditions have on life satisfaction.

Why was this study needed?

Although medical science has primarily focused on the negative outcomes of chronic conditions, looking at the effect of these conditions on positive health is equally important to help children thrive. Pediatric positive health refers to children's assessments of their well-being. Understanding the relationship between different types of chronic conditions and positive health outcomes may help clinicians promote children’s well-being and adaptability to health challenges.

The ECHO Program provides opportunities to study positive health—one of its five outcome areas—in large, diverse samples of children.

Who was involved?

Participants in this study included 1,764 children aged 8 to 17 in 13 cohorts across the United States. Of these children, 45% were teenagers, 50% were girls, 8% were Latinx, and 23% were Black. Also, 54% of participating children had a chronic physical or mental health condition.

What happened during the study?

Children completed questionnaires about their own physical, mental, and social health and life satisfaction. Parents reported on their children’s chronic health conditions, including a variety of physical, developmental, and mental health conditions.

What happens next?

More research is needed to understand the potential impact of mental health interventions, such as increasing the availability of mental health assessments for children and adolescents.

Where can I learn more?

Access the full journal article, titled “Influences of chronic physical and mental health conditions on child and adolescent positive health,” in Academic Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published: February 1, 2022

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ECHO Study Suggests Negative Associations Between Chronic Conditions and Positive Health May Be Primarily Attributed to a Co-Occurrence of Depression

Facilitators and Barriers to Pediatric Clinical Trial Recruitment and Retention in Rural and Community Settings: A Scoping Review of the Literature

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Facilitators and Barriers to Pediatric Clinical Trial Recruitment and Retention in Rural and Community Settings: A Scoping Review of the Literature

Author(s): Sara E. Watson, Paul Smith, Jessica Snowden, Vida Vaughn, Lesley Cottrell, Christi A. Madden, Alberta S. Kong, Russell McCulloh, Crystal Stack Lim, Megan Bledsoe, Karen Kowal, Mary McNally, Lisa Knight, Kelly Cowan, Elizabeth Yakes Jimenez

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What was done?

The authors conducted a review of published research papers to determine what factors make it easier or harder for children to participate in clinical research studies in rural and community-based settings. The authors considered studies to have been conducted in a “community-based setting” if all activities occurred outside of a clinic or hospital. The team reviewed other published articles to determine what strategies other researchers had used to enroll children in studies and help them stay enrolled until the studies were completed. They then looked to see which strategies were most helpful.

What was found?

In this systematic review, there were few published studies that specifically describe useful strategies for enrolling children in rural settings into clinical trials or strategies to help them stay enrolled. Strategies that have been helpful include sending families visit reminders, building relationships with community members, making it easier for families to get to study visits, and paying families for the time they spend participating in the study. Not having enough staff and resources were listed as barriers to enrolling children and helping them stay enrolled in studies.

What do the results mean?

More studies are needed to understand the best ways to engage children and their families in rural areas in clinical trials. While many of the factors identified in this review that are barriers to or supporting of research are common across all research—such as participant reminders, building relationships with families, and adequate resources—it is critical that study teams look specifically at issues important to rural communities—such as paying for travel costs and facilitating delivery of study materials to remote sites.

Why was this study conducted?

Good clinical trials can help improve patient health outcomes by informing evidence-based medicine and public health interventions. However, children and adults who live in rural settings are underrepresented in clinical trials. This can affect the quality of health care for rural populations and contribute to rural health disparities.

You may learn more about this publication here: https://ascpt.onlinelibrary.wiley.com/doi/10.1111/cts.13220

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Facilitators and Barriers to Pediatric Clinical Trial Recruitment and Retention in Rural and Community Settings: A Scoping Review of the Literature

ECHO Study Suggests Link Between Maternal Stress During Late Pregnancy and Infant Pacifier Sucking Patterns

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ECHO Study Suggests Link Between Maternal Stress During Late Pregnancy and Infant Pacifier Sucking Patterns

Author(s): Emily Zimmerman, Andréa Aguiar, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

Footnote: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What were the study results?

The researchers found that higher maternal stress during late pregnancy was associated with fewer but longer sucking bursts when the infants sucked on the special pacifier. It is important to note that the maternal stress levels and infants’ sucking behaviors between the two cohorts were different. This could be due to differences between the two cohorts’ cultures, geographical locations, ethnicities, incomes, and education levels.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is the first study investigating the link between maternal stress and infants’ sucking patterns. The results of this study may help promote awareness and earlier detection of stress exposure during pregnancy and, as a result, improve the treatment of stress-exposed infants. This study also researched these outcomes in two groups of participants with different demographics and stress levels, which may allow for earlier detection of high maternal stress exposure in lower SES populations.

Why was this study needed?

Previous studies show that a mother’s stress during pregnancy can affect her baby’s development. But less is known about how a mother’s stress during pregnancy relates to their infant’s brain function early in life. Infants’ sucking patterns have been used to measure brain function soon after birth. This study investigated whether there was any relationship between mothers’ stress in pregnancy and their young infants’ sucking patterns.

Who was involved?

The study included participants from two ECHO cohorts—one from Urbana-Champaign, Illinois and the other from Manati, Puerto Rico.

What happened during the study?

The researchers surveyed mothers regarding their stress during late pregnancy using the Perceived Stress Scale, which has 10 questions. Next, between one and eight weeks after the mothers gave birth, the researchers measured the infants’ sucking behaviors by having them suck on a pacifier connected to a pressure detector for approximately five minutes.

What happens next?

Future studies will look at the question of how early sucking behaviors relate to a child’s growth and development, in particular their brain function and cognitive development.

Where can I learn more?

Access the full journal article, titled “Examining the Association Between Prenatal Maternal Stress and Infant Non-Nutritive Suck” in Pediatric Research.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published December 16, 2021

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ECHO Study Suggests Link Between Maternal Stress During Late Pregnancy and Infant Pacifier Sucking Patterns

ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

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ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

Authors: Che-Jung Chang, Donghai Liang, et al.

Who sponsored this study?

This work was supported by the Environmental Influences on Child Health Outcomes (ECHO) program Opportunities and Infrastructure Fund, Office of the Director, National Institutes of Health, and the Environmental Protection Agency (USEPA).

Footnote: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What were the study results?

Some PFAS exposures were linked to a greater risk of low birth weight for babies that African American women delivered. PFAS exposures were also associated with the changes in the levels of small molecules needed for the baby’s development. These molecules included amino acids, lipid/fatty acids, bile acids, and sex hormones.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is one of the first studies researching the connections and relationships between exposures to PFAS, metabolomic changes during the baby’s development, and the baby’s growth. The chemical analysis showed that changes in the levels of the molecules may be responsible for the effects on birth weight. Future studies may target the important chemical mechanisms of the molecules, which may help develop early detection and intervention strategies for babies with low birth weight due to PFAS.

Why was this study needed?

Per- and polyfluoroalkyl substances (PFAS) are called “forever chemicals” because they stay in the environment a long time. PFAS exposures have been linked to adverse pregnancy and birth outcomes, such as lower birth weights, but there is little information on why this relationship exists and how PFAS exposures affect the body. Also, African American women and children are exposed to higher levels of environmental pollutants and have a higher risk of negative birth outcomes, so studies focusing on this population are very important for reducing heath disparities.

Who was involved?

This study included 313 participants enrolled in the Atlanta African American Maternal-Child ECHO cohort between March 2014 and May 2018.

What happened during the study?

Researchers collected blood samples from participants and measured the levels of PFAS and small molecules essential to a baby’s development. Using this information, the researchers calculated how the levels of the molecules changed in response to PFAS exposures and how these exposures affected the birth weight of babies.

What happens next?

The research team is working on additional analyses on the impact of exposures to PFAS before birth and the levels of essential small molecules in newborns. They are also planning to conduct larger analyses in order to get a more holistic view of the connection between PFAS exposures and adverse birth outcomes.

Where can I learn more?

For research updates, follow them on Twitter @donghai_liang, @chejung_chang, @EmoryRollins, and @EmoryHERCULES, and check out the Environmental Metabolomics Research Group’s website.

Access the full journal article, titled “Per- and polyfluoroalkyl substance (PFAS) exposure, maternal metabolomic perturbation, and fetal growth in African American women: A meet-in-the-middle approach” in Environment International.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published November 1, 2021

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ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

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ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

Authors: Brett T. Doherty, Megan E. Romano, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), and UH3 OD023275, and NIH NIEHS P42ES007373. Additional supporting entities include the Dartmouth Center for Molecular Epidemiology NIGMS, P20 GM104416) and the RTI Children’s Health Exposure Analysis Resource (CHEAR) Exposure Assessment Hub (NIEHS, U2CES026544, Fennell PI), among others

What were the study results?

Some of the chemical exposures were related to changes in the amounts of certain small molecules in the blood. Specifically, chemical exposures had the most impact on the amounts of a certain amino acids, which are the building blocks of many proteins that are important to both mother and child. When considered together, these molecule changes suggest that some of the chemical exposures may impact key health processes.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study used new tools to study how chemical exposures can affect important small molecules during pregnancy. The study results provide clues to the potential impact of these chemical exposures on the health of both mother and baby. In the future, further investigation of these chemical exposures may reveal more about their link to specific health endpoints.

Why was this study needed?

Pregnant women are exposed to chemicals in their environment. It is important to know how these chemicals might impact their health and the health of their babies. New tools can help us study how these chemicals affect health.

Who was involved?

This study included pregnant women in the New Hampshire Birth Cohort Study (NHBCS), who lived in north-central New England. A total of 177 women participated in this specific study within NHBCS.

What happened during the study?

During early pregnancy, women wore silicone wristbands for one week that captured chemicals in their environment. About three months later, the same women provided a blood sample, which was used to measure important molecules in their blood. Researchers looked at the link between environmental chemicals and the amounts of different molecules in the blood in order to better understand the health effects of these chemical exposures.

What happens next?

Going forward, it may be helpful to look for a link between the changes in molecules and related health processes and outcomes. Researchers may also want to reproduce these findings in other cohorts to better understand these environmental effects.

Where can I learn more?

Access the full journal article, titled “Chemical co-exposures assessed via silicone wristbands and endogenous plasma metabolomics during pregnancy,” is published in the Journal of Exposure Analysis and Environmental Epidemiology.

Learn about silicone wristbands at the MyExposome website.

Learn about small molecules and the methods to measure them through The UNC Nutrition Obesity Research Center (NORC) Metabolism and Metabolomics Core.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published October 26, 2021

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ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

ECHO Researchers Develop Shorter Survey for Measuring Sources of Stress in Adults

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ECHO Researchers Develop Shorter Survey for Measuring Sources of Stress in Adults

Author(s): Phillip Sherlock, Madeleine U. Shalowitz, Carolyn Berry, David Cella, Courtney K. Blackwell, Whitney Cowell, Karen M. Reyes Rodriguez, Rosalind J. Wright

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

What were the study results?

The researchers were able to reduce the 80-question CRISYS-R to just 24 essential questions, resulting in a short form CRISYS questionnaire (CRISYS-SF). The CRISYS-SF covers the same 11 areas of stress that are addressed in the CRISYS-R. Participants received very similar scores from both the CRISYS-R and CRISYS-SF.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

In large-scale studies, lengthy questionnaires can contribute to lower response rates, leading to incomplete or low-quality data. The CRISYS-SF offers doctors and researchers a way to screen for participant stress, identifying the sources of that stress, and determining the most effective interventions.

Why was this study needed?

Stress can have a significant impact on the psychological, social, and physical health of individuals. But the questionnaires that are often used to understand stress exposure can be long and burdensome. The goal of this research was to create a shorter version of the Crisis in Family Systems-Revised (CRISYS-R) that still covers all relevant areas of stress.

Who was involved?

The study included 884 pregnant women from the PRogramming of Intergenerational Stress Mechanisms (PRISM) study, which recruited pregnant women from prenatal clinics in New York City and Boston beginning in 2011. One-third of these women were born outside of the U.S., and 20% spoke Spanish as a primary language. Around 20% of participating women had less than a high school education, and 60% reported having financial trouble.

What happened during the study?

Participants completed the CRISYS-R questionnaire through an in-person or phone interview in their preferred language. The researchers used statistical methods and expert feedback to identify which questions on the CRISYS-R provided the most insight into the participant’s level of stress exposure.

What happens next?

Researchers can use the CRISYS-SF to investigate relationships between stressful life events and specific health outcomes.

Where can I learn more?

Access the full journal article, titled “A short form of the Crisis in Family Systems (CRISYS) in a racially diverse sample of pregnant women,” published in Current Psychology.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published 01 October 2021

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ECHO Researchers Develop Shorter Survey for Measuring Sources of Stress in Adults