Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Environ Pollut. 2021 Dec 15;291:118208. doi: 10.1016/j.envpol.2021.118208. Epub 2021 Sep 22.
Increasingly, studies suggest benefits of natural environments or greenness on children's health. However, little is known about cumulative exposure or windows of susceptibility to greenness exposure. Using inverse probability weighting of marginal structural models (IPW/MSM), we estimated effects of greenness exposure from birth through adolescence on executive function and behavior. We analyzed data of 908 children from Project Viva enrolled at birth in 1999-2002 and followed up until early adolescence. In mid-childhood (median 7.7 years) and early adolescence (13.1 years), executive function and behavior were assessed using the Behavior Rating Inventory of Executive Function and the Strengths and Difficulties Questionnaire (SDQ). Greenness was measured at birth, early childhood, mid-childhood, and early adolescence, using the Normalized Difference Vegetation Index. We used inverse probability weighting of marginal structural models to estimate effects of interventions that ensure maximum greenness exposure versus minimum through all intervals; and that ensure maximum greenness only in early childhood (vs. minimum through all intervals). Results of the effects of "maximum (vs. minimum) greenness at all timepoints" did not suggest associations with mid-childhood outcomes. Estimates of "maximum greenness only in early childhood (vs. minimum)" suggested a beneficial association with mid-childhood SDQ (-3.21, 99 %CI: -6.71,0.29 mother-rated; -4.02, 99 %CI: -7.87,-0.17 teacher-rated). No associations were observed with early adolescent outcomes. Our results for "persistent" maximum greenness exposure on behavior, were not conclusive with confidence intervals containing the null. The results for maximum greenness "only in early childhood" may shed light on sensitive periods of greenness exposure for behavior regulation.
越来越多的研究表明，自然环境或绿化对儿童健康有益。然而，人们对绿化暴露的累积暴露或易感性窗口知之甚少。我们使用边际结构模型的逆概率加权（Inverse Probability Weighting of Marginal Structural Models，IPW/MSM）来估计从出生到青春期的绿化暴露对执行功能和行为的影响。我们分析了 1999-2002 年出生并在 Project Viva 注册的 908 名儿童的数据，并随访至青少年早期。在儿童中期（中位数为 7.7 岁）和青少年早期（13.1 岁），使用行为评定量表的执行功能和行为评定量表（Behavior Rating Inventory of Executive Function and the Strengths and Difficulties Questionnaire，BRIEF 和 SDQ）评估执行功能和行为。在出生、幼儿期、儿童中期和青少年早期使用归一化差异植被指数（Normalized Difference Vegetation Index，NDVI）测量绿化程度。我们使用边际结构模型的逆概率加权来估计干预措施的效果，这些干预措施可确保在所有间隔内实现最大绿化程度（与最小绿化程度相比）；并确保仅在幼儿期实现最大绿化程度（与所有间隔内最小绿化程度相比）。“所有时间点最大（与最小）绿化程度”的效果估计结果表明，与儿童中期结果之间没有关联。“仅在幼儿期最大绿化程度（与最小）”的估计值表明，与儿童中期 SDQ 呈有益关联（母亲评分：-3.21，99%置信区间：-6.71,0.29；教师评分：-4.02，99%置信区间：-7.87,-0.17）。与青少年早期结果没有观察到关联。我们关于“持续”最大绿化暴露对行为的结果没有定论，置信区间包含零。“仅在幼儿期最大绿化程度”的结果可能为行为调节的绿化暴露敏感时期提供了一些启示。
