{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:24:56Z","timestamp":1765700696395,"version":"3.48.0"},"reference-count":30,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T00:00:00Z","timestamp":1731110400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"McMaster University, Hamilton, Canada"},{"name":"Bournemouth University, Bournemouth, UK"},{"name":"Nepal Health Research Council, Kathmandu, Nepal"},{"name":"America Nepal Medical Foundation, USA"},{"name":"University of Huddersfield, Huddersfield, UK"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,16]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Nepal Family Cohort study uses a life course epidemiological approach to collect comprehensive data on children\u2019s and their parents\u2019 environmental, behavioural and metabolic risk factors. These factors can affect the overall development of children to adulthood and the onset of specific diseases. Among the many risk factors, exposure to air pollution and lifestyle factors during childhood may impact lung development and function, leading to the early onset of respiratory diseases. The global incidence and prevalence of respiratory diseases are rapidly increasing, with the rate of increase in Nepal being the highest. Although the cohort will primarily focus on respiratory health, other health outcomes such as cardiovascular, metabolic and mental health will be assessed to provide a comprehensive overall health assessment. All other health outcomes are self-reported following doctor diagnosis. Some of these health outcomes will be quality controlled during the follow-up by measuring disease specific markers. Our cohort study will likely provide evidence of risk factors and policy recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Using a life-course epidemiology approach, we established a longitudinal study to address the determinants of lung health and other health outcomes from childhood to adulthood. The baseline data collection (personal data anonymised) was completed in April 2024, and 16\u2009826 participants (9225 children and 7601 parents) from 5829 families were recruited in different geographical and climate areas (hills and plains) of Nepal. We plan to follow up all the participants every 2\u20133 years.<\/jats:p>\n                    <jats:p>Descriptive analysis will be used to report demographic characteristics and compare rural and semi-urban regions. A linear regression model will assess the association between air pollution, particularly household air pollution (HAP) exposure, and other lifestyle factors, with lung function adjusted for potential confounders. A two-stage linear regression model will help to evaluate lung development based on exposure to HAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Nepal Health Research Council, Kathmandu, Nepal, and McMaster University, Hamilton, Canada. Permissions were obtained from two municipalities where the study sites are located. Parents provided signed informed consent and children their assent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Dissemination<\/jats:title>\n                    <jats:p>Findings will be disseminated through traditional academic pathways, including peer-reviewed publications and conference presentations. We will also engage the study population and local media (ie, research blogs and dissemination events) and prepare research and policy briefings for stakeholders and leaders at the local, provincial and national levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-088896","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T04:50:48Z","timestamp":1731127848000},"page":"e088896","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Nepal Family Cohort study: a study protocol"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9518-4716","authenticated-orcid":false,"given":"Om P.","family":"Kurmi","sequence":"first","affiliation":[{"name":"Centre for Healthcare and Communities, Coventry University, Coventry, UK"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Nexus Institute of Research 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