Early Psychosocial Intervention and Child and Parent Cardiovascular Disease Risk

项目总结/摘要 心血管疾病（CVD）的根源，在美国占所有死亡人数的32%，可以发现 从围产期开始虽然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CVD预防策略，并更深入地了解 心理社会家庭因素相互作用，以促进或减少心血管疾病的风险是必要的。该项目将建设 在家庭基金会（FF）干预方面，正在进行的NICHD资助的（PI：Feinberg，HD 058529）随机 对照试验围产期干预的重点是共同养育，以检查心理社会途径内 影响儿童和父母CVD风险的家庭。此外，我们还将研究潜在的干预效果 FF对儿童和父母CVD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），其中包括问卷调查和家庭互动数据收集， 基线血压，用于评估代谢和炎性CVD风险的干血斑样本 标志物和重要的CVD风险的潜在调节剂。第一，利用这些数据， 从前三波的数据收集，我们将开发互动的心理社会模型 对父母和孩子CVD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，抑郁症）和家庭气候因素（例如，养育质量， 家庭混乱和冲突），我们预计这些因素会相互作用，并以独特的方式导致CVD风险。第二、 我们将测试这些儿童、父母和家庭因素在多大程度上介导了FF干预的任何效果 关于CVD第三，我们将研究关键的外部风险因素（父母的一生社会经济地位（SES）） 和逆境和儿童的一生SES和出生体重）缓和任何协会之间的儿童，父母， 家庭因素与心血管病风险的关系以及是否调节干预对心血管病风险的主效应。这 研究将由一个专门从事干预研究的跨学科科学家小组进行， 对健康的心理社会影响，微创基于现场的生物标志物收集，以及社会经济 健康差距。该项目产生的数据将增加我们对以下途径的理解： 心理社会家庭环境影响心血管疾病的风险，以及心理社会干预是否可以 降低CVD风险。通过研究终身逆境和社会经济地位的调节作用，该研究将进一步提供信息， 未来的干预研究，以释放这种干预措施的潜力，以减少基于SES的CVD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.