PROTECT-ECHO Puerto Rico Cohort Highlighted by NIH ECHO Program
In September, the PROTECT-ECHO cohort site was spotlighted by the ECHO program for its significant contributions to knowledge of maternal and child health across Puerto Rico.
The NIH introduced the Environmental influences on Child Health Outcomes (ECHO) program in 2016 to “understand the effects of a broad range of early environmental influences on child health and development.” The program’s structure enables investigators to perform both observational and intervention research. The observational research cohort now includes more than 64,000 children. This diverse, country-wide cohort provides researchers with a large collection of data to investigate the factors that influence children’s health and well-being.
The PROTECT center was first established to study the relationship between environmental contaminants and preterm birth in Puerto Rico. With the support of ECHO funding starting in 2016, the PROTECT team was able to broaden the research scope to look at the connection between environmental and child health, specifically investigating areas like obesity, neurodevelopment, and asthma. The connection between PROTECT and ECHO research has enabled researchers to better understand the connection between the environment and maternal and child health.
In their spotlight, ECHO highlighted several impressive accomplishments by the PROTECT-ECHO team in Puerto Rico. Among them is the high participant retention rate, with 77% of participants from the first cycle of ECHO funding remaining with the study for the following cycle. This could not be done without the team always working to develop and maintain strong community trust and engagement. Their ability to adapt study approaches based on external factors and the needs of participants has also contributed to the strong retention rate. To address the lack of public transportation on the island and difficulty traveling to appointments, the team introduced solutions like satellite clinic visits, home-based assessments, and remote survey assistance. To accommodate for parents that could not bring in their children for appointments on weekdays due to jobs and other responsibilities, the team began holding weekend clinics.
Members of the PROTECT-ECHO team at a March of Dimes event
ECHO also recognized the team’s strong, direct communication and dissemination of research findings to cohort members. Over the years, the PROTECT-ECHO team has used accessible platforms like YouTube to share educational, culturally relevant content regarding environmental health risks and mitigation strategies. They have also held in-person community events at clinics, providing helpful materials for parents and hosting educational games and activities for kids to be more aware of environmental health. One of the cohort’s most important and unique communication channels is the PROTECT report-back platform, which returns chemical exposure results directly back to participants so they can better understand and support their own health.
Through strong collaboration between institutions and researchers, the PROTECT-ECHO team has been able to explore the complex relationships between environmental exposures and maternal and child health. By being acutely aware of the needs of participants and the community at large, the team has been able to utilize a study approach integrating research, education, and care coordination, resulting in significant findings and setting a precedent for other longitudinal studies.
Congratulations to our team in Puerto Rico for this well-deserved spotlight!