SPARKLED: Social Programming Affects Risk in Kids of Latent Endothelial Disease

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Project Summary/Abstract Cardiovascular complications are the leading cause of maternal mortality in the United States. The burden of poor cardiovascular health falls disproportionately on impoverished and non-White communities where structural racism limits access to quality care, thus impacting health outcomes. Social health programming (SHP) is an intervention designed to mitigate adverse social experiences by empowering communities to address modifiable risk factors for poor health. SHP for adolescents has been shown to improve health outcomes and mitigate certain cardiometabolic risk factors, including poor nutrition and exposure to psychosocial stressors. However, the long-term impacts of adolescent participation in SHP on cardiovascular health and its impact on future pregnancies are not known. In this proposal, we will partner with a nationally recognized after-school program offering SHP (Girls Inc., Omaha) to address this gap in the scientific literature. We hypothesize that SHP with nutritional and emotional resiliency components will positively impact adolescent modifiers of adult cardiovascular disease. To test this hypothesis, we will compare nutritional antioxidant status (Specific Aim 1), hair/saliva cortisol levels (Specific Aim 2), and vascular elasticity (Specific Aim 3) in current/former SHP participants versus age-matched controls. Dietary patterns and emotional resiliency will be measured using validated questionnaires. Nutritional antioxidant status (a marker of cardiovascular inflammation) will be measured using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Cortisol levels (a marker of psychological stress) will be measured in hair and saliva using enzyme-linked immunoassay (ELISA). Vascular reactivity (a marker of latent endothelial disease) with be measured using a VENDYS® test. Our research will inform the design of SHP for adolescents and contribute to the elimination of sociodemographic disparities in maternal mortality via the mitigation of cardiovascular complications. In addition to this dissertation research, I have developed a training plan to enrich my scientific and professional development as a physician-scientist trainee at the University of Nebraska Medical Center (UNMC). I will achieve the following training goals: build foundational knowledge and technical skills in pediatric health disparities, develop capacity to independently design and implement research projects, master written and verbal scientific communication skills, and integrate my clinical and scientific skillsets. Throughout my graduate training, UNMC will provide essential coursework, grant writing workshops, seminars, and other skill-building opportunities that enhance my technical expertise and professional development. Altogether, the research and training opportunities outlined in this proposal will empower me to become an adept physician- scientist and an innovative leader in the field of pediatric health disparities.