Portland, Ore.

Oregon rural children may be part of the groundbreaking, perhaps even history-making, National Children's Study. The Oregon Health & Science University Oregon Rural Practice-based Research Network (ORPRN) was just accepted into one of the pilot projects for the larger study. Clinics in eight rural communities that are members of the research network will participate including Hood River, Ontario, Baker City, Siletz, Burns, John Day, Klamath Falls and Reedsport.

"It is going to make history. This larger study will be the most important children's research ever done," said L.J. Fagnan, M.D., director of ORPRN and associate professor of family medicine, OHSU School of Medicine.

The National Children's Study will examine the effects of environmental influences on the health and development of more than 100,000 children in the United States, following them from before birth until age 21. This study is led by a consortium of federal agency partners: the U.S. Department of Health and Human Services' National Institute of Child Health and Human Development, and the National Institute of Environmental Health Sciences (both within the National Institutes of Health); and the Centers for Disease Control and Prevention as well as the U.S. Environmental Protection Agency.

The study aims to improve the health and well-being of children. The environmental effects it will be examining include natural and man-made factors; biological and chemical agents; physical surroundings; social factors; behavioral influences and outcomes; genetics; cultural and family influences and differences; and geographic locations. Much like the Framingham Heart Study, which started in 1948 with 5,209 adults, this study is expected to be one of the most comprehensive resources for improving children's health. The first results of the larger study are anticipated to be available in 2009. However, it is not yet known if OHSU will be part of the larger National Children's Study.

The pilot study in which OHSU is participating is designed to find out if practices participating in research networks are effective in collecting data on patients for the National Children's Study. In Oregon, the pilot study will include 90 pregnant women and 90 children aged 1 to 5.

Robert Law, M.D., is one of the rural physicians involved in this pilot study. "With the loss of local obstetric access, care of children has become more pressing. Continuity of care has been compromised, and some of these children fall through the cracks. Enrolling them in the National Children's Study will be a great way to add to the knowledge base about our children," he said. Law is a physician at the Dunes Family Health Care clinic in Reedsport, Ore.

By the end of August, data collection for the pilot study is expected to be complete. This information will then be reported to the National Institute of Child Health and Human Development, which will use this information to help plan the data collection for the larger study, which could begin as soon as 2005.

OHSU's rural network was one of six such practice-based research networks to qualify for this initial stage of the study to see how easy or difficult it is to collect complex data on patients in a primary care setting. The other networks chosen are located in Michigan, North Carolina, Minnesota, California and Ohio.

ORPRN was created by the Oregon Opportunity Act, passed in 2002 by the Oregon Legislature, to help increase research devoted to improving the health of rural Oregonians. ORPRN is currently working with 20 physicians' offices located in 15 rural Oregon communities. The practices include 90 primary care clinicians who provide care for more than 120,000 patients. Current ORPRN research projects include studies on immunization, osteoporosis, work flow of rural practices, and opioid prescribing and preventive care. Studies related to health information technology, literacy in primary care, colorectal cancer screening and health behavior interventions are in development. ORPRN has researchers and research coordinators located throughout the state of Oregon.

For more information about ORPRN, please visit: www.ohsu.edu/orprn. For more information about the National Children's Study, please visit: http://www.nationalchildrensstudy.gov.

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