Center for Healthier Children, Families, and Communities.
Department of Pediatrics, Geffen School of Medicine.
Pediatrics. 2022 May 1;149(Suppl 5). doi: 10.1542/peds.2021-053509C.
Advances in life course health science, systems biology, and epigenetics suggest that health development can be represented as a trajectory affected by multiple risk and protective factors arrayed in a relational developmental ecosystem across child, family, community, and systems levels. Despite tremendous potential for early life interventions at multiple levels of this ecosystem to improve children's life course health trajectories, this potential has not been fully explored. In fact, Life Course Health Development is a low priority for both health care and research funding. Representing the work of the Life Course Intervention Research Network, this supplement to Pediatrics reports on the first steps taken to define the emerging discipline of life course intervention research. Articles cover the characteristics of life course interventions together with a research framework and core competencies for this work. Topics include family, community, and youth engagement as vital components of grounding this work in health equity, family health development and its measurement, supporting children after prematurity, and new approaches to early childhood mental health. Schools and telehealth are considered innovative platforms for life course interventions, whereas cross-sector partnerships are recognized as key components of interventions to address childhood adversity. Researchers apply a Life Course Health Development lens to juvenile justice issues, including the minimum age law, and consider potential trade-offs whereby "striving" (education and income mobility) can limit "thriving" (health mobility) for people of color and those raised in low-income families. Finally, we present the Australian experience of embedding life course interventions in longitudinal studies.
生命历程健康科学、系统生物学和表观遗传学的进展表明,健康发展可以表示为受多种风险和保护因素影响的轨迹,这些因素在儿童、家庭、社区和系统层面上排列在一个关系发展生态系统中。尽管在这个生态系统的多个层面上进行早期生活干预以改善儿童的生命历程健康轨迹具有巨大的潜力,但这一潜力尚未得到充分探索。事实上,生命历程健康发展是医疗保健和研究资金的低优先级事项。本增刊代表生命历程干预研究网络的工作,报告了为定义生命历程干预研究这一新兴学科而采取的第一步。文章涵盖了生命历程干预的特征,以及这项工作的研究框架和核心能力。主题包括家庭、社区和青年参与,作为将这项工作扎根于健康公平、家庭健康发展及其测量、早产儿支持以及幼儿心理健康新方法的重要组成部分。学校和远程医疗被认为是生命历程干预的创新平台,而跨部门伙伴关系被认为是解决儿童逆境干预的关键组成部分。研究人员将生命历程健康发展视角应用于少年司法问题,包括最低年龄法,并考虑了“努力”(教育和收入流动)可能限制有色人种和低收入家庭出身的人的“茁壮成长”(健康流动)的潜在权衡。最后,我们介绍了澳大利亚在纵向研究中嵌入生命历程干预的经验。