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，使其成为终身健康和幸福的基石。 然而，经历社会逆境的儿童，如社会经济地位低下，面临更高的风险。 因为经历了情绪健康问题。根据学龄前儿童的估计，五分之一的儿童 经历情绪健康失调，这会导致危险行为，人际关系受损， 精神病理学，以及一生中的身体疾病。因此，入学是身份识别的关键点。 情绪健康问题，因为照顾者、教师和学校护士可以战略性地定位于 进行筛查和干预。为了通知有效的筛查和干预，我们需要更好地 理解社会逆境对情绪健康调节轨迹的作用及其与 入学时的功能结果，如学习成绩。此外，因为孩子的情感 监管直接受到照料的影响，我们还需要探索可改变的母性特征，包括 产妇执行功能和育儿敏感性，可作为未来干预的目标 促进儿童健康。在这份NRSA F31提案中，使用了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来解决 具体目标如下：1)确定早年社会逆境对情绪健康调节的影响 从0岁到3岁的轨迹；2)决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(即执行功能和育儿敏感性)对(A)社会联系起中介作用 逆境对情绪健康调节轨迹的影响，以及(B)情绪健康调节轨迹对学术的影响 性能。随附的职业发展计划将为我提供扩展的基础 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门知识；b)发展 掌握纵向研究的方法和分析技能；c)掌握循证护理知识 干预发展和临床翻译；d)拓展职业发展和团队科学技能。我有过 一个强大且非常成功的导师团队，致力于我的成长和发展，并将指导我 在整个奖项中都是我。总之，职业发展和研究计划将支持我的发展 社会逆境、儿童健康和福祉领域的独立护理科学家。这项建议符合 以NINR战略计划的健康为重点。这项研究将产生与 儿童情绪健康失调出现的情况，并确定潜在的可修改因素 我自己和其他人可以用来为哺乳子女-父母干预提供信息。

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.