Community Child Health Network (CCHN)'s 5-site study of preconception health of parents and fetal programming

This paper provides an overview of the NIH Community Child Health Network (CCHN) – a 5-site multidisciplinary network that includes community and academic partners, operates with explicit principles of community-based participatory research, and is conducting a first ever prospective study of preconception health of both mothers and fathers. We will present the CCHN conceptual framework for reducing health disparities associated with reproduction and child development, along with findings from >2400 families during the early post-partum period. Innovative features of the CCHN study include: (1) collecting self-reports from mothers and fathers about resources, relationship, stress levels, experiences of racism/discrimination, and social support; (2) measuring maternal allostatic load to assess biological stress indicators before, during, and after pregnancy; and (3) gathering data about neighborhood, community, and societal resources/risks hypothesized to influence pregnancy and child outcomes. The majority of study parents are low-income and not married, although often are living together just after the birth of their baby. Mothers report higher rates of depressive symptoms, lower financial resources, and different types of social supports than do fathers. Among low-income families, including those with a prior premature and/or low birth weight infant, there is considerable diversity in terms of their early post-partum experiences and their health risks for a subsequent pregnancy. These early descriptive findings will be considered in terms of how they could inform the design of novel, promising, and community-endorsed interventions to improve outcomes for a subsequent pregnancy, as well as promote healthy fetal programming and subsequent positive postnatal supports for children.