Retaining the CANDLE cohort to advance ECHO Cohort solution-oriented research and identify early-life modifiable risk factors for obesity and mental health problems in children - Over 25% of children suffer from mental health problems and/or develop obesity. Mental health problems often emerge early through a broad range of symptoms before canalizing into disorders like depression, which affects over 15% of adolescents in the U.S. Risk for obesity also increases with age from 13% in early childhood to 22% in adolescence. Childhood diseases greatly impact adult health, and alarmingly, rates of child mental health problems and obesity are increasing. Myriad early life risk and protective factors have been associated with these outcomes; however, without large national samples and systematic identification of priority exposures conferring risk or protection, clear targets for preventive interventions remain elusive. To address these critical issues, our interdisciplinary team leverages the unique power of ECHO Cohort data to conduct exposure-wide scans for early life predictors of adolescent depression and obesity to identify and prioritize the most powerful targets for prevention, with a focus on improving causal inference (Aim 1). We also take a developmentally-informed, hypothesis-driven approach to understand the intergenerational relations between maternal childhood and pregnancy stress with childhood psychopathology risk and whether associations might be buffered by family and community-level protective factors (Aim 2). To do this, we calculate a new, specialized neurodevelopmental outcome, the p-factor, which draws on multiple indicators of behavior and mental health to generate a single latent factor of general psychopathology in childhood and adolescence. This parsimonious, summary measure is ideally suited for population-based child development studies that lack deep mental health phenotyping. Finally, we retain the CANDLE cohort (700 mother-child dyads) in the ECHO Program (Aim 3). Our success collecting ECHO Cohort data and our leadership contributions to the ECHO Program are self-evident: of the 69 ECHO cohorts, CANDLE ranks #3 in records contributed to ECHO’s REDCap Central. Our team strongly contributes to collaborative science, leading multiple working groups and special projects, publishing and disseminating ECHO Cohort findings, and supporting measurement development and data harmonization. Impact: We will generate robust evidence for prevention targets, including protective factors, to mitigate the public health impact of child mental health problems and obesity. A summary measure of pediatric psychopathology (p-factor) will be useful to many investigators and is well-suited to the examination of multiple exposures. CANDLE study staff has demonstrated success in collecting complete data on participants, which supports robust ECHO-wide science. During ECHO Cycle 2, our experienced team will continue to contribute to ECHO Cohort leadership and form scientific partnerships across the Consortium to advance collaborative science and improve child health.
