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

摘要 情绪健康调节，即管理注意力、情感和行为的能力，直接关系到长期 保持健康行为，使其成为一生健康和幸福的基石。 然而，经历社会逆境的儿童，如社会经济地位低下的儿童， 情绪健康问题的人据估计，在学龄前儿童中， 经历情绪健康失调，导致危险行为，关系受损， 精神病理学和身体疾病的影响。因此，入学是一个关键点， 作为照顾者，教师和学校护士的情绪健康问题可以从战略上定位， 进行筛查和干预。为了提供有效的筛查和干预，我们需要更好地 了解社会逆境对情绪健康调节轨迹的作用及其与 入学时的功能性成果，如学习成绩。此外，由于儿童情绪 调节直接受到生育的影响，我们还需要探索可改变的母体特征，包括 母亲的执行功能和父母的敏感性，这可能是未来干预的目标， 促进儿童健康。在NRSA F31提案中，使用来自达勒姆儿童健康中心的丰富纵向数据， 和发展研究，我将采用健康和疾病的发展起源框架， 具体目标如下：1）确定早期生活社会逆境对情绪健康调节的影响 从0岁到3岁的轨迹; 2）确定情绪健康调节轨迹是否与 入学时的学习成绩（幼儿园，一年级）;以及3）确定是否可以修改 母亲的特征（即执行功能和养育敏感性）介导（a）社会 逆境情绪健康调节轨迹，和（B）情绪健康调节轨迹，以学术 性能随附的职业发展计划将为我提供基础a）扩展 在早期生活逆境对儿童发展和情绪健康调节的影响方面的专业知识; B）发展 纵向方法的方法和分析技能; c）获得循证护理知识 干预发展和临床翻译; d）扩大职业发展和团队科学技能。我有 一个强大而成功的导师团队，致力于我的成长和发展，并将指导 在整个颁奖过程中。职业发展和研究计划将共同支持我的发展， 在社会逆境，儿童健康和福祉领域的独立护理科学家。该提案与 与NINR战略计划的健康重点。这项研究将产生重要的知识， 儿童情绪健康失调的情况，并确定潜在的可改变的因素， 我自己和其他人可以用来告知护理儿童的父母干预措施。

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.