Frontiers in Pediatrics (Jun 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,
  • Leonardo Trasande,
  • Andrew Law,
  • Courtney K. Blackwell,
  • Lisa P. Jacobson,
  • Theresa M. Bastain,
  • Carrie V. Breton,
  • Amy J. Elliott,
  • Assiamira Ferrara,
  • Margaret R. Karagas,
  • Judy L. Aschner,
  • Judy L. Aschner,
  • Nicole Bornkamp,
  • Carlos A. Camargo,
  • Sarah S. Comstock,
  • Anne L. Dunlop,
  • Jody M. Ganiban,
  • James E. Gern,
  • Catherine J. Karr,
  • Rachel S. Kelly,
  • Kristen Lyall,
  • T. Michael O’Shea,
  • Julie B. Schweitzer,
  • Kaja Z. LeWinn

DOI
https://doi.org/10.3389/fped.2023.1171214
Journal volume & issue
Vol. 11

Abstract

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ObjectiveOngoing 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.MethodsECHO 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.ResultsThis 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.ConclusionECHO 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.

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