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

项目概要/摘要 候选人：Nia Heard-Garris，MD，MSc是一名儿科医生和初级临床研究者，专注于 研究青少年心脏代谢健康（CMH）的社会风险因素， 心脏代谢疾病的发展。Heard-Garris博士的长期职业目标是开发有效的 针对青少年的干预措施，以减轻整个儿童时期逆境对CMH的负面影响。 寿命拟议的培训和研究活动将有力地支持Heard-Garris博士成为一名 独立的医生调查员检查和解决青少年CMH的社会风险因素。 研究背景：近3400万美国儿童经历过一次或多次不良童年经历 （ACES）18岁。ACE驱动生理和行为变化，减少应对和增加压力， 使成年人易患心脏代谢疾病。然而，ACE对青春期CMH的影响 目前尚不清楚，降低ACE相关CMH风险的干预策略尚不成熟。 青春期是一个理想的时间来检查，以确定ACE最强烈相关的CMH和发展 在青少年过渡到成年之前，干预ACES-CMH通路。 具体目标：1）确定ACE、CMH相关行为和CMH之间的关系， 青少年; 2）适应应对和减压（CEDARS）干预青少年ACE在一个 儿科临床环境; 3）试点适应性CEDARS，为临床环境中暴露于ACE的青少年量身定制。 研究计划：为了实现这些目标，Heard-Garris博士将收集ACE和CMH数据， 青少年和进行分析，以更好地表征ACES-CMH途径;调整CEDARS， 通过焦点小组在临床环境中使用;实施和评估CEDARS。 职业发展计划：Heard-Garris博士将学习整合医学和社会科学方法 研究ACE和CMH的方法。她将获得青少年CMH的专业知识， 积极情绪和减压的干预措施。Heard-Garris博士将拓宽她的专业技能。博士 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; 专家顾问团的指导;体验式实验室沉浸;高级教学课程工作; 出席专业会议;参加研讨会;以及执行其研究计划。这 培训将直接有助于她设计有效干预措施的目标，以解决CMH的风险 青少年，以及随后提交的一个成功的R34临床试验规划补助金和R 01。 Heard-Garris博士拥有一个由NIH资助的核心导师和咨询团队，他们致力于 指导她独立她得到了西北大学和卢里儿童医院的支持， 这两个国家都拥有出色的研究基础设施，并坚定地致力于支持初级研究人员。

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.