The Role of Social Adversity on Trajectories of Child Emotional Health Regulation

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ABSTRACT Emotional health regulation, the ability to manage attention, affect and behavior, is directly related to long term maintenance of health behaviors making it a cornerstone for wellness and wellbeing across the lifespan. However, children who experience social adversity, such as low socioeconomic status, are at heightened risk for experiencing emotional health problems. By preschool age, estimates indicate that one in five children experience emotional health dysregulation, which lead to risky behaviors, impaired relationships, psychopathology, and physical illness across the lifespan. Thus, school entry is a critical point for identification of emotional health problems as caregivers, teachers, and school nurses can be strategically positioned to conduct screening and interventions. To inform effective screening and intervention, we need to better understand the role of social adversity on emotional health regulation trajectories and its relationship with functional outcomes at school entry, such as academic performance. Additionally, because child emotional regulation is directly affected by caregiving, we also need to explore modifiable maternal characteristics including maternal executive functioning and parenting sensitivity which could be targeted for future intervention to promote child wellness. In this NRSA F31 proposal, using rich longitudinal data from the Durham Child Health and Development Study, I will adopt the Developmental Origins of Health and Disease framework to address the following specific aims: 1) Determine early life social adversity's effect on emotional health regulation trajectories from ages 0 to 3 years; 2) Determine whether emotional health regulation trajectories associate with academic performance outcomes at school entry (kindergarten, 1st grade); and 3) Identify whether modifiable maternal characteristics (i.e. executive function and parenting sensitivity) mediate the association of (a) social adversity to emotional health regulation trajectories, and (b) emotional health regulation trajectories to academic performance. The accompanying career development plan will provide the foundation for me to a) expand expertise in the effects of early life adversity on child development and emotional health regulation; b) develop methodological and analytic skills in longitudinal approaches; c) acquire knowledge in evidence-based nursing intervention development and clinical translation; d) expand career development and team science skills. I have a strong and highly successful mentorship team that is dedicated to my growth and development and will guide me throughout this award. Together, the career development and research plan will support my development as an independent nursing scientist in the area of social adversity, child health and well-being. This proposal aligns with the wellness focus of the NINR Strategic Plan. This study will generate important knowledge related to the conditions in which childhood emotional health dysregulation arise and identify potential modifiable factors that myself and others can use to inform nursing child-parent interventions.