ACHiP-ACEs and Cardiometabolic Health in Pediatrics: Using a Coping and Stress Reduction Intervention to Reduce Cardiometabolic Risk in Adolescents with Adversity

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PROJECT SUMMARY/ABSTRACT Candidate: Nia Heard-Garris, MD, MSc is a pediatric physician and a junior clinical investigator focused on examining the social risk factors of adolescent cardiometabolic health (CMH) and reducing the risk of the development of cardiometabolic disease. Dr. Heard-Garris’s long-term career objective is to develop effective interventions for adolescents that mitigate the negative influence of childhood adversity on CMH throughout the lifespan. The training and research activities proposed will strongly support Dr. Heard-Garris in becoming an independent physician-investigator examining and addressing the social risk factors of CMH in adolescents. Research Context: Nearly 34 million US children experience one or more adverse childhood experiences (ACEs) by age 18. ACEs drive physiological and behavioral changes, reduced coping and increased stress, predisposing adults to cardiometabolic disease. However, the influence of ACEs on CMH in adolescence remains unclear, and intervention strategies to reduce ACEs-related CMH risk are underdeveloped. Adolescence is an ideal time to examine to identify the ACEs most strongly associated with CMH and develop interventions to interrupt the ACEs-CMH pathway, before adolescents transition into adulthood. Specific Aims: 1) Determine the relationship between ACEs, CMH-related behaviors, and CMH in adolescents; 2) Adapt a Coping and Stress Reduction (CEDARS) intervention for adolescents with ACEs in a pediatric clinic setting; 3) Pilot the adapted CEDARS, tailored to ACE-exposed adolescents in a clinical setting. Research Plan: To accomplish these aims, Dr. Heard-Garris will collect ACEs and CMH data from adolescents and conduct analyses to better characterize the ACEs-CMH pathway; adapt the CEDARS to be used within a clinical setting through focus groups; and implement, and evaluate the CEDARS. Career Development Plan: Dr. Heard-Garris will learn to integrate medical and social science methodological approaches to study ACEs and CMH. She will acquire expertise in adolescent CMH and develop competency in positive-emotion, stress-reduction interventions. Dr. Heard-Garris will broaden her professional skills. Dr. Heard-Garris’s career development goals will be well-supported by an interdisciplinary core mentorship team; guidance from an expert advisory panel; experiential lab immersions; advanced didactic course work; attendance at professional meetings; participation in seminars; and implementation of her research plan. This training will directly contribute to her goal of designing effective interventions that address CMH in at-risk adolescents, as well as the subsequent submission of a successful R34 clinical trial planning grant and R01. Environment: Dr. Heard-Garris has a NIH-funded core mentorship and advisory team who are dedicated to mentoring her to independence. She is supported by Northwestern University and Lurie Children’s Hospital, both with outstanding research infrastructures and strong commitments to supporting junior investigators.