Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

PROJECT SUMMARY/Abstract: The overarching goal of this ECHO COVID-19 Administrative Supplement (NOT-OD-20-107) is to examinechanges in children's obesity-related behaviors that are occurring in tandem with societal changes related tothe COVID-19 pandemic. Prolonged home stays, physical distancing precautions, school closures andeconomic disruption may impact children's dietary intake, physical activity, screen time and sleep. This is acritical gap to fill because obesity prevention and treatment interventions over the next several years will needto be tailored to address the COVID-19-specific causes of obesity. Societal changes may differentially impactchildren from different socioeconomic and racial/ethnic groups and, in turn, exacerbate existing disparities inobesity. Further, variation in the degree of protective measures varies by US state, which may contribute togeographic variation in the effects of the pandemic on child health. Natural experiments are needed to assessthe effects of the pandemic on obesity-related behaviors in a socioeconomically, ethnically and geographicallydiverse sample of children using rigorous measures of diet, activity, screen time and sleep. KaiserPermanente Northern California (KPNC) is 1 of 4 awardees in the ECHO consortium proposing to collaborateon this Administrative Supplement. We propose a quasi-experimental pretest-posttest design among mother-child dyads from the 4 ECHO sites cohorts (n=375 dyads), including KPNC which consists of two pre-birthcohorts currently following offspring in early childhood. For the pretest, we will leverage existing data on diet,activity, screen time and sleep collected from dyads who completed their ECHO visit before March 2020. Forthe posttest, we will collect novel repeated measures data in Fall 2020 and Spring 2021 from the same dyadsusing remote data collection. We will address the following specific aims: AIM 1: to compare diet, activity,screen time and sleep prior to versus during the pandemic, with a focus on identifying children at high risk foradverse changes. We will explore whether the changes in obesity-related behaviors are modified bysocioeconomic status, race/ethnicity and site location: AIM 2: using a mixed method approach (qualitative andquantitative), examine families' daily routines during the pandemic, and parent perceptions of how societalchanges influence children's obesity-related behaviors. The ECHO COVID-questionnaire will quantitativelyexamine parent perceptions of how societal changes influence obesity-related behaviors. Qualitative interviewswith parents will identify COVID-specific barriers to achieving healthy behaviors, reduced access to physicalspaces that promote active play, and parents' reliance on screen time as a replacement for in-person daycare.This study will be significant for ECHO and the broader child health community because lifestyle behaviorchanges during the pandemic may alter obesity risk and amplify existing obesity disparities. Findings from thisstudy will inform programs, policy and practice to prevent childhood obesity during the pandemic and beyond.