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Published on: February 14, 2019
Feasibility of home-based urine collection in children under 5 years in the ORIGINS birth cohort study: mixed method
Courtney D A Kidd1, Najma A Moumin2,3, Andrea MacRae4
1Telethon Kids Institute, North Entrance Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia. Courtney.Kidd@telethonkids.org.au.
Insights
Home-based urine collection is feasible for large-scale studies in young children. This approach, using mixed methods, successfully collected samples for nutritional status and population health surveys.
Area of Science:
- Pediatric Health Research
- Biomarker Discovery
- Population Health Surveys
Background:
- Urine is a valuable, non-invasive biospecimen for assessing nutritional status and health in young children.
- Current research often limits urine collection to clinical settings, hindering large-scale, representative population studies.
- The feasibility of at-home urine sample collection in this demographic remains largely untested.
Purpose of the Study:
- To assess the feasibility and acceptability of a mixed-method, home-based urine collection strategy in a large cohort of children under five years old.
- To establish a scalable method for collecting urine samples for nutritional and biomarker research in early childhood.
Main Methods:
- The ORIGINS Project employed a mixed-method approach for longitudinal urine sample collection from 3713 children (aged 2 months to 5 years).
- Methods included courier collection and postal kit delivery, incorporating participant feedback to overcome barriers like in-person drop-offs.
- Data collection occurred in Perth, Australia, from 2017 to 2022.
Main Results:
- Over 52% of eligible caregivers (1929/3713) returned urine samples, with 91% meeting quality standards.
- Courier collection accounted for one-third of samples, showing highest use in infants (2-6 months) and increased overall uptake during COVID-19 lockdowns.
- Caregivers identified time constraints as the primary barrier, with minimal reported difficulty using the provided study methods.
Conclusions:
- Home-based urine collection, utilizing a mixed-method approach, is a scalable and acceptable strategy for caregivers of young children.
- This method supports the broader use of urine samples for biomarker studies and population health surveys in pediatric populations.
- The findings demonstrate the potential for non-invasive, at-home biospecimen collection to enhance the representativeness of large cohort studies.
Background:
Urine is an attractive biospecimen for nutritional status and population health surveys. It is an excellent non-invasive alternative to blood for appropriate biomarkers in young children and is suitable for home-based collection, enabling representative collections across a population. However, the bulk of literature in this population is restricted to collection in primary care settings. Feasibility of home-based collection at scale has not been tested. Here, we describe a mixed method approach to collect urine samples in a large cohort study with children under 5 years.
Methods:
The ORIGINS Project is an ongoing birth cohort investigating early life influences on child health outcomes in Perth, Australia. Recruitment began in 2017, with 3713 children consented by December 2022. Urine is collected longitudinally from children between 2 months and 5 years of age. Mixed methods for sample collection and return accommodates requirements across various ages and study timepoints. Uniquely, courier collection and postal kit deliveries were established in response to participant feedback regarding difficulty with in-person sample drop-offs with young children.
Results:
Over half of all eligible caregivers (1929/3713, 52%) returned a sample, 91% meeting quality standards. A third of all samples were returned by courier, with the highest uptake at 2-6 months of age, and increased uptake across all ages during COVID lockdowns. Caregivers cited being time-poor as the greatest barrier to sample completion and very few participants indicated difficulty with study methods.
Conclusion:
Our data suggests that home-based urine collection using a mixed method approach is acceptable to caregivers at a large scale, supporting the use of urine for biomarker studies and population surveys with young children.
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