# Environmental influences on Child Health Outcomes - The Colorado ECHO Pediatric Cohort

> **NIH NIH UG3** · UNIVERSITY OF COLORADO DENVER · 2023 · $1,612,834

## Abstract

PROJECT SUMMARY/ABSTRACT
Chronic conditions, such as obesity, asthma, depression, and developmental disabilities, are increasing among
children worldwide. Further, the age at diagnosis for many such conditions is decreasing, pointing to early-life
origins. The developmental origins of health and disease (DOHaD) paradigm posits that exposures and
experiences in utero and during early life influence phenotype and physiology as well as behaviors that shape
lifelong health. Epidemiologic studies of DOHaD phenomena have historically focused on single exposure-health
outcome associations, despite calls for more holistic approaches to capture the totality of exposures and their
causal pathways. Other important limitations of prior work include homogenous study samples that diminish
generalizability and limit opportunities to identify disparities and infrequent or lack of granularity in assessment
of exposures and health outcomes across ontogeny. Together, these limitations hamper identification of when
and how risk factors and combinations of risk factors across early life culminate in chronic disease. This proposal
addresses the above gaps by leveraging the Environmental influences on Child Health Outcomes (ECHO)
Program to investigate a broad range of early-life exposures, from society to biology, in relation to pediatric
health outcomes among ~50,000 caregiver-offspring pairs. The Colorado team will implement ECHO’s Core and
Specialized Protocols in the Healthy Start Study, a Colorado pre-birth cohort that recruited and followed 1,250
mother-child dyads. In this cohort, exposures, and outcomes relevant to ECHO were collected during pregnancy,
at birth, during infancy and the toddler years, and in early childhood (4-5 years). In the first ECHO Cycle, the
Colorado team followed 765 children, to date, through middle childhood (8-12 years) and transferred extant data
from pregnancy onward to the ECHO platform. In response to RFA-OD-22-019 and in collaboration with other
ECHO components, our team will implement the ECHO Cohort Data and Biospecimen Collection Protocol with
high fidelity and use community-engaged retention strategies to follow 900 diverse participants aged 11-19 years
to achieve two scientific objectives: (1) characterize patterns of structural, chemical, and physical exposures
during the in utero period and early childhood that predict co-occurring clusters of major ECHO outcomes through
adolescence; and (2) examine joint effects of exposure to in utero overnutrition and childhood psychosocial
adversity on the Specialized Outcome of pediatric obesity. The work proposed will facilitate a holistic
understanding of how the totality of early-life exposures and experiences shape chronic disease risk in children;
examine the involvement of a potentially modifiable biological mechanism (DNA methylation); and provide
insights into multi-level targets for preventive action, including family- and individual-level factors that build
resiliency in the...

## Key facts

- **NIH application ID:** 10744571
- **Project number:** 2UG3OD023248-08
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Traci Allison Bekelman
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,612,834
- **Award type:** 2
- **Project period:** 2016-09-21 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10744571

## Citation

> US National Institutes of Health, RePORTER application 10744571, Environmental influences on Child Health Outcomes - The Colorado ECHO Pediatric Cohort (2UG3OD023248-08). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10744571. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*