environmental factors, both health adverse and health promoting. Plans for the National Children’s Study are to enroll pregnant women as early in preg- nancy as possible and to enroll a subset of the cohort before conception. Current plans are to follow 100,000 births to adulthood (21 years of age), with collection of data on exposures and outcomes at points throughout the study. Two major goals of the study are to use the longitudinal design as a way to link exposures with outcomes that occur at different points in time (i.e., exposure may precede the resulting outcome by months or years) and to explore interactions among various factors, including genetic traits. The general design and adminis- trative structure are described by the National Children’s Study Interagency Coordinating Committee (2003) and the Study Plan (National Children’s Study 2005). Planning for this large study began in mid-2000 with the initiation of a number of methods development studies, particularly the development of less burdensome and less costly exposure assessment methods (U.S. EPA 2004a). Other efforts have included labo- ratory studies on noninvasive procedures for analysis of biomarkers of exposures and out- comes (Rockett et al. 2002), development of comparable measures that could be adminis- tered in children and laboratory animal mod- els enabling further exploration of exposure– outcome links in animal studies (Sharbaugh et al. 2003), and field studies using focus groups to explore recruitment and retention issues. A number of reviews and white papers have been developed, including an evaluation of advanced technology for capturing data, a review of the leading hypotheses of the effects of environmental factors on children’s health outcomes, and a review of the leading sampling strategies for consideration in the study. In addition, a resource database on biomarkers of exposures and outcomes was developed (U.S. EPA 2004b). More recently, a number of workshops have been organized to explore and reﬁne the measures that might be included in the protocol for the study. A complete listing of workshops, meetings, and reports can be found at the National Children’s Study website (2005). Because of the research being conducted by the Children’s Centers, a good deal of expertise and specialized knowledge have already been developed that can be particularly valuable to the development of protocols for the National Children’s Study. As detailed below, much of the work of the original eight centers was on pesticide exposures and neurodevelopment, and air pollution and asthma. The four additional Children’s Centers are focusing on develop- mental disabilities, particularly autism spectrum disorders, and the impact of various environ- mental pollutants on learning and behavior. These and other exposures and outcomes have been established as priorities for the National Children’s Study (Table 1). Thus, the Children’s Centers have experience in sev- eral of the priority focus areas that should provide valuable input to the design of the National Children’s Study. In addition to these priority focus areas, it is recognized that community participation and involvement are key to the success of the National Children’s Study. The study design is likely not to be strictly community based, but rather will involve multiple sites through- out the country with a complex multilevel sampling strategy for obtaining the most rep- resentative population possible for inclusion in the study. Perhaps the greatest lesson to be learned from the Children’s Centers is the myriad of logistical complexities to be consid- ered in an intensive investigation of children’s exposure and health outcomes. The cumula- tive experience of the Children’s Centers in conducting community-based participatory research, particularly in underserved popula- tions, will provide valuable information for future studies. The NIEHS/U.S. EPA Centers for Children’s Environmental Health and Disease Prevention Research The same federal executive order that spawned the National Children’s Study also led to development of the Children’s Centers. The NIEHS and U.S. EPA collaborated in 1998 to develop a research program that would bring together efforts to better understand the expo- sures of infants and young children, study the health effects of such exposures to better understand the mechanisms by which they work, and explore intervention strategies for reducing such exposures in a way that would provide evidence for practice. The program was funded in two phases; the first phase in 1998 funded eight centers, and four more centers were funded in 2001. In 2003, a new round of competition was completed and seven awards were made. Six of the pre- existing centers continue to date, and a new center was added. The motivation for this pro- gram and a summary of the ﬁrst eight centers has been more fully discussed by Dearry et al. (1999) and O’Fallon et al. (2000). A full description of the Children’s Centers can be found on the NIEHS website (NIEHS 2005). The purpose of the Children’s Centers program is 2-fold: ﬁrst, to create local research environments that promote multidisciplinary interactions among basic, clinical, and behav- ioral scientists through university/community partnering in order to accelerate translation of basic research ﬁndings into clinical preven- tion or intervention strategies; and second, to Environmental Health Perspectives • VOLUME 113 | NUMBER 10 | October 2005 Lessons learned: NIEHS/EPA Children’s Centers support a coordinated nationwide network of scientists and community advocacy groups synergistically sharing their experiences to address relevant questions related to the role of environmental exposures in the health of chil- dren in order to enhance community-level capacity to identify and address environmental threats and prevention opportunities. The aims of establishing this national network are to foster communication, innovation, and excellence in children’s environmental health; to provide training opportunities for scientists and clinicians for future development of this ﬁeld of study; and to broaden the national dis- cussions between diverse groups of commu- nity advocates and organizers on common interests in protecting and nurturing healthy environments for children. Each center is designed around a central theme focusing on important questions in understanding the role of exposures in one of the following health outcome areas: respiratory disease, childhood learning, and growth and development including developmental disabili- ties. Exposures to toxicants such as polychlori- nated biphenyls (PCBs), mercury, lead, air pollution, allergens, agricultural and urban pesticides, second-hand smoke, and others are part of the Centers Program’s research priori- ties. All centers have multiple projects across scientific disciplines, from basic laboratory- based research and genetics to exposure assess- ment, epidemiology, and clinical trials. Methods have been developed, ﬁeld tested, and implemented to detect and define health symptoms and outcomes; new exposure tech- nology has been developed to assess environ- mental exposures and body burden in a diverse array of biospecimens; and creative approaches to reaching and retaining traditionally “hard to follow” socioeconomic groups have been implemented with community input. Over the past 5 years and using a variety of methods, scientists from the NIEHS/U.S. EPA Children’s Centers Program have made a number of advances that would not have been possible without the establishment of a coordi- nated network of centers to foster multi- and interdisciplinary research targeted at under- standing children’s environmental health risks and reducing them. Many of the results of Table 1. Priority health outcomes and exposure areas identiﬁed for the National Children’s Study. Priority health and disease outcomes Pregnancy outcomes Neurodevelopment and behavior Childhood injury Asthma Obesity and physical development Priority environmental exposures and other factors Physical exposures and environment Chemical exposures Biologic environment and genetics Psychosocial environment and exposures 1415