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: 10683955
• 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/10683955
• 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; Dedications; Development; Development Plans; Diabetes Mellitus; Disparity; Eligibility Determination; 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; Risk Reduction; Social Sciences; Stress; Stress and Coping; Testing; Time; Training; Training Activity; United States National Institutes of Health; Universities; Work; Youth; acceptability and feasibility; adverse childhood events; 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; neglect; 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; trial planning; 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.

项目摘要/摘要 候选人：医学博士Nia Heard-Garris是一名儿科身体，专注于初级临床研究者 检查青少年心脏代谢健康（CMH）的社会风险因素，并降低了 心脏代谢疾病的发展。 Heard-Garris博士的长期职业目标是发展有效 减轻儿童广告对CMH的负面影响的青少年的干预措施 寿命。提出的培训和研究活动将强烈支持Heard-Garris博士成为一个 独立的物理评估者检查并解决青少年中CMH的社会风险因素。 研究环境：近3400万我们的儿童经历了一种或多种不利的童年经历 （ACE）到18岁。ACES驱动生理和行为变化，应对减轻和压力增加， 诱使成年人患心脏代谢疾病。但是，ACE对青少年CMH的影响 尚不清楚，降低与ACE相关的CMH风险的干预策略欠发达。 青春期是检查以确定与CMH最密切相关的ACE并发展的理想时机 在青少年过渡到成年期之前，要中断ACES-CMH途径的干预措施。 具体目的：1）确定ACE，与CMH相关行为和CMH之间的关系 青少年； 2）适应A中的ACE的青少年的应对和压力减轻（CEDAR）干预 小儿诊所； 3）在临床环境中量身定制的适应于ACE暴露的青少年的改装雪松。 研究计划：为了实现这些目标，Heard-Garris博士将从 青少年和进行分析以更好地表征ACES-CMH途径；适应雪松 通过焦点小组在临床环境中使用；并实施并评估雪松。 职业发展计划：Heard-Garris博士将学会整合医学和社会科学方法论 研究ACE和CMH的方法。她将获得青少年CMH的专业知识并发展能力 在阳性情绪中，减少压力干预措施。 Heard-Garris博士将扩大她的专业技能。博士 Heard-Garris的职业发展目标将由跨学科的核心心态团队良好支持； 专家咨询小组的指导；专家实验室沉浸；高级教学课程工作； 参加专业会议；参加半手；并实施她的研究计划。这 培训将直接有助于她设计有效干预措施，以解决高危CMH 青少年以及随后提交成功的R34临床试验计划赠款和R01的提交。 环境：Heard-Garris博士拥有NIH资助的核心精神和咨询团队，他们致力于 指导她独立。她得到西北大学和卢里儿童医院的支持 既有出色的研究基础设施，又有对支持初级研究人员的坚定承诺。