Environmental influences on Child Health Outcomes (ECHO) is a multi-site program supported by the National Institutes of Health (NIH). Researchers at DOR have been part of the ECHO program since 2016, when they received an initial grant of $24 million for a pediatric study to follow for 7 years a diverse group of 2,130 children. The participants were children of individuals who were previously enrolled in DOR pregnancy studies.
In 2023, DOR researchers received an additional $22 million for the pediatric study to continue following the 2,130 children for an additional 7 years — until 2030. Researchers also received a new $42 million, 7-year grant to establish a new pregnancy cohort of 1,800 diverse pregnant individuals who will be followed over time, together with their children.
The ECHO program gives investigators an opportunity to study the effects of a wide range of environmental exposures that include chemicals but also diet, physical activity, stress, neighborhood, and other psychosocial factors on pregnant individuals and children’s health.
The ECHO program is unique: researchers from across the U.S. collaborate, with approximately 50,000 children and their families participating, providing the largest study of environmental factors on children’s health to date.
Ongoing pediatric project
DOR research scientists Assiamira Ferrara, MD, PhD, and Lisa Croen, PhD, were the principal investigators for the original ECHO pediatric grant. They will continue to follow the initial study group for another 7 years, in partnership with Research Scientist Monique Hedderson, PhD, who is joining the project as a principal investigator.
Additional investigators working on the ongoing ECHO pediatric study include DOR research scientists Lyndsay Avalos, PhD, MPH, Yeyi Zhu, PhD, Stacey Alexeeff, PhD, Sylvia Badon, PhD, Jennifer Ames, PhD, and Luis Rodriguez, PhD, along with staff scientists Rana Chehab, PhD, and Alicia Peterson, PhD. and research fellow Luke Grosvenor, PhD.
Each year, ECHO participants answer surveys and come to a Kaiser Permanente facility or have a video visit for additional health assessments.
DOR studies supported by the initial ECHO pediatric funding have documented increased screen time for children during the COVID-19 pandemic, potential associations of in-utero exposure to environmental chemicals with a child’s autistic traits and obesity, association between maternal depression and child’s autistic traits, how a healthy lifestyle can lead to lower risk of preterm birth and appropriate weight at birth, and how a healthy diet during pregnancy can have lasting health effects on the child by improving infant size at birth and optimizing growth trajectory during the first two years of life.
The researchers plan to continue studying prenatal exposure to environmental chemicals and potential associations with childhood health outcomes such as obesity and neurodevelopment. Another focus will be effects on children of maternal factors such as diet quality, gestational diabetes, and weight gain during pregnancy.
More about the pediatric cohort is available on the project website.
New pregnancy-oriented project
The new pregnancy study will be overseen by principal investigators Hedderson, Avalos, and Zhu. Additional investigators working on the new study include DOR research scientists Assiamira Ferrara, Sylvia Badon, Ben Marafino, PhD, Susanna Mitro, PhD, and Ousseny Zerbo, PhD, along with research fellows Ana Rosen Vollmar, PhD, CPM, LM, Shalmali Bane, PhD, and Bethany Hallenbeck, PhD.
The main research focus will be on how prenatal exposure to environmental factors — such as psychological distress, substance use, maternal diet, physical activity and sleep — impacts childhood obesity and neurodevelopment.
The study will also consider whether social factors such as economic and racial makeup of participants’ neighborhoods may mitigate these associations.
A main goal for study recruitment for this new pregnancy cohort is expanding socioeconomic, racial, and ethnic diversity of participants. Recruitment will be focused on Oakland, Richmond, Berkeley, Alameda, and Pinole.
More information about the ECHO Family Study is available on the project website.
More about ECHO
The national ECHO Coordinating Center maintains a website with materials for the public, including research summaries of ECHO-funded studies from ECHO investigators across the U.S. It also features an August 2022 webinar about Division of Research work on mental health and lifestyle exposures featuring Assiamira Ferrara, Monique Hedderson, and Lyndsay Avalos.
