Early Psychosocial Intervention and Child and Parent Cardiovascular Disease Risk

项目摘要/摘要 心血管疾病(CVD)的根源可以找到，在美国，心血管疾病占所有死亡人数的32% 在早年，从围产期开始。尽管在广泛的人群中进行心理社会干预 年龄范围已被证明可以改善行为、心理健康和身体健康结果， 制定有效的早期心血管疾病预防战略，并更深入地了解 需要心理社会家庭因素的相互作用来促进或降低心血管疾病风险。拟议中的项目将建立 关于家庭基金会(FF)干预，正在进行的由NICHD资助的(PI：Feinberg，HD058529)随机 一项围产期干预的对照试验，重点是生育，以检查 影响儿童和父母心血管疾病风险的家庭。此外，我们还将研究潜在的干预效果 对儿童和父母心血管疾病风险的影响。作为拟议项目的一部分，我们将增加计划中的家访 (n=294个家庭)，包括问卷和家庭互动数据收集，增加了 用于评估代谢和炎症性心血管疾病风险的基线血压、干血斑样本 标记物和心血管疾病风险的重要潜在调节因子。首先，使用这些数据并利用数据 从之前的三波数据收集中可以获得，我们将开发互动心理社会模型 对父母和子女心血管疾病风险的影响。具体而言，这将包括对儿童因素的考虑(例如， 行为问题)、父母因素(例如，抑郁)和家庭环境因素(例如，育儿质量， 家庭混乱和冲突)，我们预计它们会相互作用，并以独特的方式增加心血管疾病风险。第二, 我们将测试这些孩子、父母和家庭因素在多大程度上调节了FF干预的任何影响 在心血管疾病上。第三，我们将检查关键的外部风险因素(父母的终生社会经济地位(SES)) 而逆境和孩子一生的社会支持和出生体重)缓和了孩子、父母、 以及家庭因素与心脑血管疾病风险的关系以及它们是否缓和了干预对心脑血管疾病风险的主效应。这 研究将由专门从事干预研究的跨学科科学家团队进行， 心理社会对健康、微创现场生物标记物收集和社会经济的影响 健康差距。这个项目产生的数据将通过以下途径增加我们对路径的理解 心理社会家庭环境对心血管疾病风险的影响以及心理社会干预是否可以 降低心血管疾病风险。通过考察终生逆境和社会经济状况的调节作用，这项研究将进一步揭示 未来的干预研究，以释放这种干预的潜力，以减少基于SES的心血管疾病差异。

Project Summary/Abstract The roots of cardiovascular disease (CVD), which is responsible for 32% of all deaths in the U.S., can be found during the early years, beginning perinatally. Although psychosocial interventions in populations across a wide age range have been shown to improve behavioral, mental health, and physical health outcomes, the development of effective early CVD prevention strategies and a deeper understanding of the ways in which psychosocial family factors interact to promote or reduce CVD risk are needed. The proposed project will build on the Family Foundations (FF) intervention, an ongoing NICHD-funded (PI: Feinberg, HD058529) randomized controlled trial of a perinatal intervention focused on coparenting, to examine the psychosocial pathways within the family that influence child and parent CVD risk. Additionally, we will examine potential intervention effects of FF on child and parent CVD risk. As part of the proposed project, we will augment the planned home visits (N = 294 families) which include questionnaire and family interaction data collection by adding the collection of baseline blood pressure, dried blood spot samples for the assessment of metabolic and inflammatory CVD risk markers, and important potential moderators of CVD risk. First, using these data and taking advantage of data available from three previous waves of data collection, we will develop models of interactive psychosocial influences on parent and child CVD risk. Specifically, this will include the consideration of child factors (e.g., behavioral problems), parent factors (e.g., depression), and family climate factors (e.g., parenting quality, family chaos and conflict), which we expect to interact and also contribute to CVD risk in unique ways. Second, we will test the extent to which these child, parent, and family factors mediate any effect of the FF intervention on CVD. Third, we will examine whether key external risk factors (parents’ lifetime socioeconomic status (SES) and adversity and children’s lifetime SES and birth weight) moderate any associations between child, parent, and family factors and CVD risk and whether they moderate main effects of the intervention on CVD risk. This research will be conducted by an interdisciplinary team of scientists who specialize in intervention research, psychosocial influences on health, minimally invasive field-based biomarker collection, and socioeconomic health disparities. The data resulting from this project will increase our understanding of the pathways through which the psychosocial family environment influences CVD risk and whether a psychosocial intervention can reduce CVD risk. By examining the moderating role of lifetime adversity and SES, the study will further inform future intervention research to unlock the potential of such interventions to reduce SES-based CVD disparities.