Health and educational organizations in Polk County along with The University of Iowa have been selected to participate in a National Health Investigation (NHI) on the interaction of genes and the environment with regard to children’s health.
Jeff Murray, MD, principal investigator of the contract pediatrician at University of Iowa Children’s Hospital, talks about the five year contract with NHI:
What will this study look at specifically in children’s health care?
This will be a 25-year study in which the goal is to identify the environmental and genetic causes of common diseases of children like asthma, autism, preterm delivery, and the increasing epidemic of childhood obesity.
How many other centers will be involved in the NHI study nationally?
There will be 105 centers involved across the U.S. These centers have been selected to give a broad representation of the types of diverse populations that we have in the U.S.
Will all Iowa participants live in Polk County?
All of the participants in this study will live in Polk County. There will be a one-year long process in which various communities within Polk County will be selected as representative of the entire county. Once that process is finished, individuals will be enrolled.
How will participants be recruited for the study?
There will be widespread advertisements about the project that will take place the year before it begins. We will hire individuals who will literally go door to door and ask if there are any women in the home who are likely to have a child in the next few years; and if so, if they’d be willing to participate.
What will study participants be asked to do as part of the study?
They’ll be asked to allow examination of their medical records that will be collected both during pregnancy and then following the individual child. There will be detailed examinations of the children, looking at things like their cognitive and physical development. There will also be detailed questionnaires that will sample environmental exposures and nutritional factors in the home.
What information do you hope to gain from this study on both a short- and long-term basis?
On the short-term basis, we hope to identify some of the risk factors for early childhood diseases. Things like mothers who are affected with preeclampsia, preterm labor, or low birth weight. Long-term, we hope that some of the problems that show up later in childhood in the asthmas, the autisms, the diabetes, these kinds of things, will have information disclosed about their environmental and genetic contributions. The goal is that we’ll be able to use that information in some way to help provide better care for the kids.
What challenges does this type of study present?
One of the challenges is identifying people who are both willing to participate and who are willing to continue their involvement for the 25-year course of the study. It’s important that we get a very representative group of individuals—both in Polk County and across the U.S. And it’s also important that we’re able to demonstrate to the community that this is going to be a valuable and important project and so the community will embrace it.
How are the results of this NHI study expected to change the way children are treated medically?
In the short-term, we hope it will identify environmental factors that play a role in the onset of childhood diseases. That would include things like:
- Cigarette smoking that we already know about
- Nutrition, where we would have the opportunity to modify the factor by giving information to parents
- Environmental exposures that children have and making improvements
In the long-term, we hope this will help us identify new epidemics that might occur in children. Childhood obesity, for example, is a relatively recent phenomenon. We expect there may be other developments as well, and by collecting information, we’ll be able to identify and prevent those as quickly as possible.
When will recruitment officially start?
Nationally the recruitment will start in January at sites in Wisconsin and South Dakota; and in Polk County, we expect we’ll start in about two years.
This sounds very ambitious. Has something like this been done before?
Nothing like this has ever been done before in the United States. A couple of the Scandinavian countries, Norway and Denmark, have done similar projects but not nearly on the scale that we’re attempting here, and without nearly the depth of environmental data that we will collect. We believe that the environment is a very important contributor to childhood illness and this will be the first time that the kinds of detail sampling and collections will have been carried out. |
