title: Characterizing a "Big Data" Cohort of Over 200,000 Low-Income U.S. Infants and Children for Obesity Research: The ADVANCE Early Life Cohort.
abstract: Introduction Low-income populations have elevated exposure to early life risk factors for obesity, but are understudied in longitudinal research. Our objective was to assess the utility of a cohort derived from electronic health record data from safety net clinics for investigation of obesity emerging in early life. Methods We examined data from the PCORNet ADVANCE Clinical Data Research Network, a national network of Federally-Qualified Health Centers serving >1.7 million safety net patients across the US. This cohort includes patients who, in 2012-2014, had ≥1 valid body mass index measure when they were 0-5 years of age. We characterized the cohort with respect to factors required for early life obesity research in vulnerable subgroups: sociodemographic diversity, weight status based on World Health Organization (<2 years) or Centers for Disease Control (≥2 years) growth curves, and data longitudinality. Results The cohort includes 216,473 children and is racially/ethnically diverse (e.g., 17.9% Black, 45.4% Hispanic). A majority (56.9%) had family incomes below the Federal Poverty Level (FPL); 32% were <50% of FPL. Among children <2 years, 7.6 and 5.3% had high and low weight-for-length, respectively. Among children 2-5 years, 15.0, 12.7 and 2.4% were overweight, obese, and severely obese, respectively; 5.3% were underweight. In the study period, 79.2% of children had ≥2 BMI measures. Among 4-5 year olds, 21.9% had >1 BMI measure when they were <2 years. Discussion The ADVANCE Early Life cohort offers unique opportunities to investigate early life determinants of obesity in the understudied population of low income and minority children.
authors.affiliation: OHSU-PSU School of Public Health, 3181 SW Sam Jackson Park Rd., Mail Code CB669, Portland, OR, 97239-3098, USA. boonej@ohsu.edu.
authors.forename: J
authors.identifier: 0000-0002-0368-0545
authors.initials: J
authors.lastname: Boone-Heinonen
authors.affiliation: OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Tillotson
authors.affiliation: OHSU-PSU School of Public Health, 3181 SW Sam Jackson Park Rd., Mail Code CB669, Portland, OR, 97239-3098, USA.|OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: O'Malley
authors.affiliation: OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.|Department of Family Medicine, OHSU, 3181 SW Sam Jackson Park Rd., Mail Code FM, Portland, OR, 97239-3098, USA.
authors.forename: E K
authors.initials: EK
authors.lastname: Cottrell
authors.affiliation: OHSU-PSU School of Public Health, 3181 SW Sam Jackson Park Rd., Mail Code CB669, Portland, OR, 97239-3098, USA.|OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Gaudino
authors.affiliation: Health Choice Network, 9064 NW 13th Terrace, Miami, FL, 33172, USA.
authors.forename: A
authors.initials: A
authors.lastname: Amofah
authors.affiliation: Health Choice Network, 9064 NW 13th Terrace, Miami, FL, 33172, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Rivo
authors.affiliation: Health Choice Network, 9064 NW 13th Terrace, Miami, FL, 33172, USA.
authors.forename: A
authors.initials: A
authors.lastname: Brickman
authors.affiliation: The Fenway Institute, 1340 Boylston St., Boston, MA, 02215, USA.
authors.forename: K
authors.initials: K
authors.lastname: Mayer
authors.affiliation: Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: McBurnie
authors.affiliation: OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.|Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
authors.forename: R
authors.initials: R
authors.lastname: Gold
authors.affiliation: OCHIN, 1881 SW Naito Parkway, Portland, OR, 97201, USA.|Department of Family Medicine, OHSU, 3181 SW Sam Jackson Park Rd., Mail Code FM, Portland, OR, 97239-3098, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: DeVoe
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019992:Databases as Topic; D057286:Electronic Health Records / Q000458:organization & administration; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D063766:Pediatric Obesity / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology
keywords: Child; Infant; Longitudinal; Obesity; Socioeconomic factors