The Environmental Influences on Child Health Outcomes (ECHO) study is a nation-wide research project funded by the National Institutes of Health (NIH). ECHO researchers are interested in discovering how the environment can impact child health and wellbeing. The ECHO program focuses on the following key health outcomes: pregnancy and birth, lung health , brain development, nutrition and body weight, and overall wellbeing. All of the information and samples that you and your child provide will give ECHO valuable information about one or more of those health outcomes. The ECHO study looks at “environmental influences” that affect child health. What do you mean when you say “environment” in this context?

The ECHO study consists of many separate research sites across the United States. ECHO Boston is a collection of research sites that collects information and samples from residents living in the Greater Boston area. The ECHO Boston team includes research scientists, medical professionals, and research staff. Click here to learn more about the ECHO Boston team.

We value your participation! By participating in ECHO Boston, you are contributing to a nationwide study on child health and wellbeing. You are providing researchers with valuable scientific information on pregnancy, parenthood, and childhood, and the environment that surrounds us all. You are helping ECHO scientists develop better healthcare practices, programs, and policies. With your collaboration, we hope to create a healthier, safer world for your children.

During your prenatal participation, you will receive up to $75 deposited onto a ClinCard (reloadable debit card). For each completed childhood research visit, as a thank-you for your participation, you can receive up to $100 in Target e-gift cards. We will also pay for your parking for the entire day or reimburse your public transit costs.

At your prenatal and perinatal visits, medical professionals will be present to answer your questions and provide medical advice. These visits are built into your regular appointments at either Beth Israel Deaconess Medical Center or Bowdoin Street Health Center. After the birth of your baby, you can expect to work with our dedicated team of ECHO Boston research assistants at the Harvard Pilgrim Health Care Institute. The ECHO Boston research assistants are educated, trained professionals who are passionate about improving child health outcomes. However, the HPHCI research assistants are not doctors and cannot provide medical advice to you or your child. Please contact your child’s pediatrician with any questions or concerns you may have about your child. You can read more about the ECHO Boston research staff here.

No. ECHO is an observational study, meaning that we simply collect data and look for connections. The ECHO Boston staff will not ask participants to test new drugs or medical treatments.

The ECHO study began in 2016. ECHO Boston began recruiting pregnant participants in 2024 at Beth Israel. At the current moment, we have over 100 ECHO pregnancies and over 50 ECHO babies.

In general, ECHO scientists use the samples to look for hormones, nutrients, chemicals, and other environmental exposures. We can learn about the food you eat, the water you drink, and the environment you live in using these samples. Your samples help the ECHO study understand how genes and the environment work together to influence children’s growth and development. During the 0-5 month visit, we may request the following samples: Child urine, stool, and blood spot Maternal blood spot, hair, and saliva Blood and saliva samples can provide genetic information and help identify genes associated with health conditions. Urine samples can provide the ECHO study with insights about chemical exposures and how the body reacts to harmful chemicals. Stool samples help ECHO researchers understand the bacteria that reside in the digestive system. Finally, ECHO researchers use hair samples to study nutritional deficiencies and exposure to harmful chemicals.

We’ll do our very best! We offer early morning, evening, and weekend appointments. It is very important to us and the research study that we see as many of our participants as possible in-person. If for some reason you don’t see a time offered that suits your schedule, reach out to our team and we can accommodate your needs! If it is more convenient for you, our research assistants can drive to you to complete a visit from the comfort of your own home.

Yes. We are more than willing to pause the visit if you need to feed or change your baby. Our visit room includes a changing table and diapers and wipes. You will also be able to use our office’s private infant feeding room.

Guests are welcome to join you for the visit. However, the ECHO Boston visit room is quite small; your loved one may prefer to wait downstairs at the Time Out Market.

Yes. You will need to sign two consent forms: one for yourself, and one for your baby. These will provide consent to participate at the new study site, Harvard Pilgrim Health Care Institute, but will contain nearly identical information to the one that you signed when first enrolling in the study.

The stool sample is taken directly from your child’s dirty diaper after they have a bowel movement. We will ship you a kit to help you collect this sample. The kit contains three tubes, which have spoon-like tool attached to the top that can be used to scoop up a portion of the stool. We ask that you please bring the samples with you to your scheduled visit. The urine sample is also taken from your child’s diaper. To collect this sample, an ECHO research assistant will place small cotton pads inside the diaper. After your child urinates, we will remove the urine-soaked cotton pads for lab processing. To collect the blood spot sample, a research assistant will quickly prick your child’s heel with a sterile lancet and let 5 drops of blood fall onto a blood spot card. You may choose to opt out of this collection. All sample collections are quick and minimally invasive.

To collect the blood spot, you will be provided with a sterile lancet and asked to prick your finger. You will let 5 drops of blood fall onto a blood spot card. For the saliva collection, we will provide you with a tube and ask that you spit into the tube until the tube is filled. For the hair sample, an ECHO research assistant will cut several small samples of your hair. We will take care to cut from the back of the head, near the nape of your neck, to make the hair collection unnoticeable. All sample collections are quick and minimally invasive.

The ECHO Boston team will always wear gloves or use clean hands when collecting samples from your baby. We also have masks on hand and are happy to wear them during the visit if that would make you feel most comfortable.

For the most part, no. The ECHO study anonymizes and aggregates all biospecimen and survey results. While we cannot share individual findings, ECHO scientists often publish their general scientific findings. You can view the most recent ECHO publications here. Occasionally, if the researchers see results that they believe are very important to your child’s health or medical care, we will give you a report with the information and an explanation of what each result means. We will also let you know if we think you should share the results with a doctor or other health professional.

We acknowledge that mistakes happen. The ECHO surveys are designed to take that into account. Throughout the course of your ECHO participation, you will very likely be asked similar questions in a variety of ways in order to more accurately capture your information. If you incorrectly entered information that you would want us to have accurate (such as your address or your demographics), please send us an email explaining the situation.

Yes. ECHO Boston offers remote research visits for participants who have moved. You and your child will be able to complete the visit components from the comfort of your own home. Please let us know if you are moving, or have recently moved, and we can reach out to you about remote visits.

Unfortunately, no. We cannot conduct research visits with participants who have moved abroad. If you end up moving back to the United States, you may resume your participation.

Yes. You may pause your participation in the study at any time. Please inform the staff of your decision by emailing us at ECHO@hphci.harvard.edu. Please include a brief reason for the pause. Come back to ECHO whenever you’re ready; we’re flexible and always grateful for your participation!

When your child reaches 6 months of age, we will ask your partner (if applicable) if they would like to participate in the ECHO study. We are interested in your current partner at this time— this may or may not be your child’s second biological parent. In general, we are interested in understanding how partners influence child development, health, and wellbeing. One specific reason that ECHO recruits partners is because we are trying to collect data from couples who may plan to have another baby. We would like to see if parents’ health behaviors before conception can influence their future child. There is now emerging evidence that parents’ health before conception—before the sperm and egg have even met—may impact their future child’s health and wellbeing. Partner involvement in the ECHO study is a one-time opportunity. We will ask your partner to complete surveys about their health habits, as well as their physical, emotional, and social health. We will follow up with some partners and ask them to provide saliva and urine samples. Your partner’s participation shouldn’t take long, and they will be able to provide valuable information for our study. Your partner will also receive a Target gift card as a thank you for their participation. We greatly appreciate you and your partner’s contributions to this groundbreaking line of research.

We will ship our partner participants the collection materials and instructions. ECHO partners will be able to collect the samples in the privacy of their own homes. There are 3 options for how to return the samples back to ECHO. You can view these options here.

We will send you an email with this information! Look for an email from ECHO Boston with the subject line “New Opportunity in ECHO Boston: Your Current Partner’s Participation – Please Share!” This email will have the link for your partner to sign up for the study.

No worries! You will still be able to participate fully in the ECHO study. If your partner is still deciding, please let them know we are happy to answer any questions or concerns they may have. They can email us or call us, and we’ll get back to them as soon as possible.