The National Children's Study Research Plan A Review (2008) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-14
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the National Institute of Child Health and Human Development to conduct a national longitudinal study of environmental influences (including physical, chemical, biological, and psychosocial) on children's health and development." In response to this act, the National Institute of Child Health and Human Development (NICHD)
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The panel concludes that the NCS offers an excellent opportunity to examine the effects of environmental influences on child health and development, as well as to explore the complex interactions between genes and environments. If the NCS is conducted as proposed, the database derived from the study should be valuable for investigating hypotheses described in the research plan as well as additional hypotheses that will evolve.
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The use of established random selection methods at each sampling stage will ensure that the NCS samples of households, eligible women of childbearing age, and births are national probability samples. We endorse the study's decision to use probability sampling without oversampling any groups.
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More centralized and conventional models, such as that employed by the large National Longitudinal Study of Adolescent Health, appear more likely to produce high-quality data. Given that the decentralized approach could not readily be altered at this stage because contracts already have been signed, it will be incumbent upon the government to ensure that staff and other resources are sufficient to closely monitor data collection activities and take prompt remedial steps as necessary.
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The list of proposed variables about which we have raised questions includes: birth defects, pregnancy outcomes (including fetal death) , child mental health disorders, maternal depression, brain injuries, reproductive development outcomes, nonpersistent organic chemicals, pesticides, childhood infections, and the social environment in the home.
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Some of the decisions -- for example, regarding transmitting information about fetal defects encountered through ultrasounds -- are urgent to make. Clearer plans must also be developed regarding what parents and children need to be told about emerging research findings.
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In addition, funding uncertainties make it difficult to plan beyond the relatively short period for which funds have been appropriated. Like the scientists associated with the study itself, we are eager for it to succeed.
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Throughout the life of the study, the NCS should use the Vanguard Centers to pilot test and experiment with data collection methods and instrumentation. Pregnancy Outcomes Recommendation 3-1: The NCS should consider replacing research on sub clinical maternal hypothyroidism as a factor in adverse pregnancy outcomes with research on the effects of a broader set of maternal physical and mental health conditions, such as maternal depression, maternal perceived stress, and maternal periodontal disease.
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. Hormonally Active Agents and Reproductive Development Recommendation 3-7: The NCS should develop refined and detailed protocols for studying reproductive development outcomes, which, as presented in the research plan, often lack clarity in measurement and research design.
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Recommendation 3-13: The NCS should dedicate a portion of funds to support research and development of reliable and valid instruments of key psychosocial measures that are practical and economical to administer. Biological Exposure Measures Recommendation 3-14: The NCS should review some of the proposed measures of biological exposures, such as maternal glucose metabolism and child cortisol levels, to ensure that the proposed times for data collection are appropriate for capturing the underlying exposure.
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Missing Exposures Recommendation 3-17: The NCS should add measures of access to and qual ity of services, including medical care, education, child care, and services, as potential mediators of health and development outcomes and to improve the as sessment of information obtained through maternal reports. Data Linkage Recommendation 3-18: To facilitate linkages of NCS data with environmental exposures from other databases, such as measures of demographics, crime, government programs, and pollution, the NCS should develop a plan for geocod ing the residential addresses from prebirth through adulthood of all participating children to standard census geographic units.
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Recommendation 4-6: The NCS should prepare a plan for monitoring progress of the study in reaching its sample size goals. As part of the plan, the NCS should take advantage of the experience of the Vanguard Centers to evaluate initial en rollment rates, the effectiveness and potential respondent burden of the interview instrument, and the ability of the Vanguard Centers to obtain the required house hold environmental measures reliably.
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To protect respondent confidentiality, all analyses should be performed with the kind of strict safeguards employed by the Census Bureau research data centers. Community Engagement Recommendation 5-3: The NCS should engage communities in selected study implementation, data analysis, and data interpretation activities that go beyond recruitment.
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