Children and (future) Parents, supported by Prediction and Professionals in Prevention, to improve Opportunity (C-4PO)
Hoe kan je (aanstaande) ouders ondersteunen tijdens de eerste 1000 dagen?
De ontwikkeling van een kind tijdens de zwangerschap en de eerste twee jaar van het leven heeft invloed op de gezondheid en ontwikkeling tijdens het hele leven. In dit project wordt onderzocht hoe (aanstaande) ouders in deze periode het beste kunnen worden ondersteund.
Bijvoorbeeld welke kenmerken in het vroege leven samenhangen met ongunstige ontwikkeling of gezondheidsproblemen op een later moment? Daarbij wordt gebruik gemaakt van gepseudonimiseerde gegevens over de gezondheid en ontwikkeling van honderdduizenden kinderen die al wat ouder zijn, binnen de beveiligde data-omgeving van het Centraal Bureau voor de Statistiek (CBS).
Het project gaat in drie regio’s met ouders én professionals in de geboortezorg en de jeugdgezondheidszorg aan de slag met de resultaten van het onderzoek. Door vroegtijdig inzicht te krijgen in de situatie van een kind, kunnen zij samen besluiten op welke manier (aanstaande) ouders het beste ondersteund kunnen worden. De gegevens blijven achter slot en grendel bij het CBS.
How to support (future) parents during the first 1000 days?
A child's development during pregnancy and the first 2 years of life affects health and development throughout life. This project investigates how (future) parents can best be supported during this period.
For example, which characteristics in early life are associated with unfavorable development or health problems later on? Pseudonymised data on the health and development of hundreds of thousands of older children will be used, within the secure data environment of Statistics Netherlands (CBS). The research data will also remain under lock and key at CBS.
In 3 regions, the project will work with parents and professionals in maternity care and youth health care with the results of the research. By gaining an early insight into a child's situation, they can jointly decide how (future) parents can be supported best.
Samenvatting van de aanvraag
In the Netherlands, many children are born with a suboptimal start in life. 16% of children are born prematurely or are small for gestational age. Experiences during the first 1000 days after conception and during childhood have long-lasting and even transgenerational implications, with people growing up in an extremely unfavorable environment on average dying twenty years earlier. An unfavorable intra-uterine and early childhood developmental environment is associated with a wide range of non-communicable disease, such as diabetes, cardiovascular disease, schizophrenia and obesity. A vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development. Hence, there is a strong need for early detection and prevention of unfavorable developmental conditions, both because of the impact at the individual level, but also for bringing forward society as a whole and reducing avoidable loss of health and developmental potential. The Netherlands has one of the most accessible and well-developed health care systems in the world, with universal health insurance coverage and the highest patient satisfaction in Europe. Preventive care during gestation and the first years of life is nearly universal, free to parents and their children, and highly standardized in terms of provision and registration. The standardized collection of data on pregnancies, pregnancy outcomes, and the health and development of all Dutch children offers exceptional opportunities to personalize preventive and curative health care in the first thousand days after conception, and to give children a healthy start in life. Prenatal and early childhood investments have been shown to be among the most effective and efficient ways to spend public funds, a finding which has been described as the Heckman curve. However, the Dutch system is currently missing out on important opportunities to “personalize” obstetrics, midwifery and preventive youth health care (PYHC, Jeugdgezondheidszorg in Dutch). Personalizing health care can offer budget-neutral improvements by ensuring that care reaches those who need it and who benefit most, and can be scaled up or down according to need. We have identified two opportunities to improve personalization of universal, selective, and indicated prevention. First, the data which are collected in health care practice are currently not used to their full potential to support medical professionals in their decision-making process. Second, even in the Dutch system, where obstetrics, midwifery and preventive youth health care is universally and pro-actively provided, a set of (future) parents cannot or choose not to use parts of these services, limiting the system’s early detection and prevention capabilities. This project aims to remove these barriers to personalized, effective, and efficient care during the first thousand days after conception. In co-creation with (future) parents and obstetrics, midwifery and preventive youth health care professionals, we will harness rich but underused data sources to build a data-driven support tool to guide professionals in shared decision-making with (future) parents. Next, we will evaluate whether those tools will improve decision-making, targeting, and uptake of care activities. Furthermore, we will clean and document novel PYHC data, to make these data reusable for other researchers through the remote access environment of Statistics Netherlands (CBS). Finally, we will inform the public discourse about the legal and practical measures that are in place to protect the privacy of Dutch citizens.