ACHiP-ACEs and Cardiometabolic Health in Pediatrics: Using a Coping and Stress Reduction Intervention to Reduce Cardiometabolic Risk in Adolescents with Adversity

ACHiP-ACE 和儿科的心脏代谢健康：使用应对和减压干预措施来降低逆境青少年的心脏代谢风险

• 批准号: 10225581
• 负责人: Nia Jenee' Heard-Garris
• 金额: $ 16.2万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225581
• 关键词: Address; Adolescence; Adolescent; Adolescent Development; Adrenal Glands; Adult; Adverse event; Advisory Committees; Affect; Age; Automobile Driving; Award; Behavior; Behavioral; Blood Pressure; Blood specimen; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Child; Childhood; Chronic stress; Clinic; Clinical; Clinical Investigator; Clinical Trials; Communities; Competence; Data; Data Analyses; Development; Development Plans; Diabetes Mellitus; Emotional; Enrollment; Environment; Exercise; Family; Focus Groups; Functional disorder; Funding; Future; Goals; Grant; Health; Health behavior; Hearing; Heart Diseases; Hypertension; Hypothalamic structure; Immersion; Individual; Inflammatory; Institution; Insulin Resistance; Interruption; Intervention; Learning; Life; Life Cycle Stages; Longevity; Low income; Measurement; Measures; Medical; Mentors; Mentorship; Methodology; Minority; Mission; Moods; National Heart, Lung, and Blood Institute; Obesity; Outcome; Outpatients; Participant; Pathway interactions; Patient Self-Report; Patients; Pediatric Hospitals; Pediatrics; Physicians; Physiological; Pituitary Gland; Population; Positioning Attribute; Questionnaires; Reporting; Research; Research Activity; Research Infrastructure; Research Personnel; Risk; Risk Factors; Social Sciences; Stress; Stress and Coping; Testing; Time; Training; Training Activity; United States National Institutes of Health; Universities; Work; Youth; abuse neglect; acceptability and feasibility; adverse childhood events; base; biological adaptation to stress; cardiometabolic risk; cardiometabolism; career; career development; childhood adversity; cigarette smoking; cohort; coping; design; dietary; disorder risk; effective intervention; evidence base; experience; fasting glucose; follow-up; health data; high risk; hypothalamic-pituitary-adrenal axis; implementation barriers; implementation intervention; improved; innovation; meetings; member; novel strategies; peer; population health; positive emotional state; prevent; primary care setting; prospective; psychological distress; randomized trial; recruit; response; skills; sleep quality; social; stress reduction; usability

PROJECT SUMMARY/ABSTRACT Candidate: Nia Heard-Garris, MD, MSc is a pediatric physician and a junior clinical investigator focused on examining the social risk factors of adolescent cardiometabolic health (CMH) and reducing the risk of the development of cardiometabolic disease. Dr. Heard-Garris’s long-term career objective is to develop effective interventions for adolescents that mitigate the negative influence of childhood adversity on CMH throughout the lifespan. The training and research activities proposed will strongly support Dr. Heard-Garris in becoming an independent physician-investigator examining and addressing the social risk factors of CMH in adolescents. Research Context: Nearly 34 million US children experience one or more adverse childhood experiences (ACEs) by age 18. ACEs drive physiological and behavioral changes, reduced coping and increased stress, predisposing adults to cardiometabolic disease. However, the influence of ACEs on CMH in adolescence remains unclear, and intervention strategies to reduce ACEs-related CMH risk are underdeveloped. Adolescence is an ideal time to examine to identify the ACEs most strongly associated with CMH and develop interventions to interrupt the ACEs-CMH pathway, before adolescents transition into adulthood. Specific Aims: 1) Determine the relationship between ACEs, CMH-related behaviors, and CMH in adolescents; 2) Adapt a Coping and Stress Reduction (CEDARS) intervention for adolescents with ACEs in a pediatric clinic setting; 3) Pilot the adapted CEDARS, tailored to ACE-exposed adolescents in a clinical setting. Research Plan: To accomplish these aims, Dr. Heard-Garris will collect ACEs and CMH data from adolescents and conduct analyses to better characterize the ACEs-CMH pathway; adapt the CEDARS to be used within a clinical setting through focus groups; and implement, and evaluate the CEDARS. Career Development Plan: Dr. Heard-Garris will learn to integrate medical and social science methodological approaches to study ACEs and CMH. She will acquire expertise in adolescent CMH and develop competency in positive-emotion, stress-reduction interventions. Dr. Heard-Garris will broaden her professional skills. Dr. Heard-Garris’s career development goals will be well-supported by an interdisciplinary core mentorship team; guidance from an expert advisory panel; experiential lab immersions; advanced didactic course work; attendance at professional meetings; participation in seminars; and implementation of her research plan. This training will directly contribute to her goal of designing effective interventions that address CMH in at-risk adolescents, as well as the subsequent submission of a successful R34 clinical trial planning grant and R01. Environment: Dr. Heard-Garris has a NIH-funded core mentorship and advisory team who are dedicated to mentoring her to independence. She is supported by Northwestern University and Lurie Children’s Hospital, both with outstanding research infrastructures and strong commitments to supporting junior investigators.

项目概要/摘要 候选人：Nia Heard-Garris，医学博士、理学硕士，是一名儿科医师和初级临床研究员，专注于 检查青少年心脏代谢健康（CMH）的社会风险因素并降低青少年心脏代谢健康的风险 赫德-加里斯博士的长期职业目标是开发有效的心脏代谢疾病。 对青少年采取干预措施，减轻童年逆境对整个儿童时期 CMH 的负面影响 拟议的培训和研究活动将有力支持赫德-加里斯博士成为一名 独立医师调查员检查并解决青少年 CMH 的社会风险因素。 研究背景：近 3400 万美国儿童经历过一种或多种不良童年经历 (ACE) 到 18 岁时。ACE 会导致生理和行为变化，减少应对能力并增加压力， 然而，ACEs 对青少年 CMH 的影响。 仍不清楚，并且降低 ACE 相关 CMH 风险的干预策略尚未制定。 青春期是检查以确定与 CMH 最密切相关的 ACE 并发展的理想时期 在青少年过渡到成年之前进行干预以中断 ACEs-CMH 通路。 具体目标： 1) 确定 ACE、CMH 相关行为和 CMH 之间的关系 2) 对患有 ACE 的青少年采取应对和减压 (CEDARS) 干预措施 儿科诊所环境；3) 试行针对临床环境中接触 ACE 的青少年量身定制的 CEDARS。 研究计划：为了实现这些目标，Heard-Garris 博士将收集 ACE 和 CMH 数据 青少年并进行分析，以更好地描述 ACEs-CMH 途径的特征； 通过焦点小组在临床环境中使用；并实施和评估 CEDARS。 职业发展计划：赫德-加里斯博士将学习整合医学和社会科学方法论 她将获得青少年 CMH 方面的专业知识并培养能力。 赫德-加里斯博士将拓展她的专业技能。 Heard-Garris的职业发展目标将得到跨学科核心导师团队的大力支持； 专家顾问小组的指导；体验式实验室浸入式课程； 出席专业会议；参加研讨会；以及实施她的研究计划。 培训将有助于她设计有效干预措施来解决高危人群的 CMH 问题 青少年，以及随后成功提交的 R34 临床试验计划拨款和 R01。 环境：Heard-Garris 博士拥有 NIH 资助的核心指导和顾问团队，致力于 她得到了西北大学和卢里儿童医院的支持， 两者都拥有出色的研究基础设施和对支持初级研究人员的坚定承诺。