Project STRIVE (STudents RIsing above) - Offsetting the health and mental health costs of resilience

STRIVE 项目（以上学生）——抵消复原力的健康和心理健康成本

• 批准号: 10608168
• 负责人: ANNA Shan-Lai LAU
• 金额: $ 66.97万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10608168
• 关键词: Academic achievement; Academic skills; Achievement; Adolescent; Aftercare; Anxiety; Asian Americans; Automobile Driving; Behavioral; Biological; Biological Markers; Black race; Black, Indigenous, People of Color; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular system; Chronic stress; Color; Complex; Development; Disadvantaged; Educational Curriculum; Eligibility Determination; Emotions; Enrollment; Exhibits; First Generation College Students; Health; Health Care Costs; Hip region structure; Hydrocortisone; Informal Social Control; Institutional Racism; Interruption; Intervention; Latinx; Link; Mediating; Mediator; Mental Health; Metabolic; Metabolic syndrome; Mindfulness Training; Modeling; Morbidity - disease rate; Neck; Neurosecretory Systems; Outcome; Physiological; Population; Poverty; Prevention trial; Problem behavior; Process; Public Participation; Qualifying; Race; Randomized; Research; Resources; Risk; Role; Schools; Secondary Schools; Site; Socialization; Students; Study Skills; Symptoms; Testing; Youth; allostatic load; anxiety symptoms; attentional control; children of color; college; cost; depressive symptoms; early life adversity; early life stress; emotion regulation; ethnic minority; examination questions; experience; externalizing behavior; health disparity; inclusion criteria; indexing; intervention effect; marginalized community; mindfulness intervention; mindfulness-based stress reduction; minority children; minority student; physical conditioning; prevent; preventive intervention; randomized trial; resilience; skills; social capital; socioeconomic disadvantage; success; therapy design

PROJECT SUMMARY Students in marginalized communities who `strive' to rise above adversity to achieve academic success are considered `resilient'. However, youths' resilience in one domain (i.e. academic) can come at a cost in other domains including physical and mental health morbidities that are under-identified and under-treated. Previous research suggests that Black, Indigenous and People of Color (BIPOC) who exhibit a “striving persistent behavioral style” in the face of adversity evince later health morbidities. Ironically, the same self- regulatory skills that promote academic achievement amid chronic stress can also result in physiological dysregulation that harms health and mental health1–3. Self-regulatory processes that involve emotion suppression, experiential avoidance, and unmodulated perseverance can culminate in allostatic load which fuels health disparities1,4 and internalizing symptoms of depression and anxiety5. The proposed mechanistic trial will utilize mindfulness training to permit examination of questions about the causal role of emotion regulation strategies linked to the striving persistent behavioral style in driving mental health and health morbidities among BIPOC78. The proposed Project STRIVE (STudents RIsing aboVE) will identify BIPOC students who are academically resilient in the face of disadvantage and will offer a tailored mindfulness intervention targeting self-regulation processes as a putative mechanism to interrupt the links between the striving persistent behavioral style and negative health outcomes. We propose a multisite randomized trial randomizing 504 high achieving, socioeconomically disadvantaged Black, Latinx and Asian American students in 18 schools to receive a mindfulness intervention or an attention control condition focused on study skills. The study will: (1) test the effects of the STRIVE intervention on putative self-regulation mechanisms (emotion suppression, experiential avoidance, and unmodulated perseverance) among. (2) test the effects of the STRIVE intervention on health and mental health outcomes at 12-month post-treatment, including biomarkers of allostatic load (cortisol, blood pressure, body-mass-index, waist/hip/neck circumference), health complaints, and internalizing symptoms, and (3) examine the mechanistic model linking striving persistent behavioral style and health outcomes within the STRIVE trial. If successful, this trial will build toward a scalable, secondary preventive intervention with potential for preventing both health and mental health disparities among underserved BIPOC youth at the population-level.

项目摘要 “努力”克服逆境以取得学业成功的边缘化社区的学生 被认为是“顺从的”。然而，年轻人在一个领域（即学术）的适应力可能会在以下方面付出代价： 其他领域，包括未充分识别和治疗的身心健康疾病。 以前的研究表明，黑人，土著和有色人种（BIPOC）谁表现出“努力”， 面对逆境时的“持久行为方式”表明了以后的健康问题。具有讽刺意味的是，同样的自我- 在慢性压力下促进学业成就的调节技能也会导致生理上的 危害健康和心理健康的失调1 -3。涉及情绪的自我调节过程 抑制、经验性回避和未调节的毅力可以在非稳态负荷中达到顶峰， 促进健康的能力1，4和抑郁症和焦虑症的内在症状5。 拟议的机械试验将利用正念训练，允许检查以下问题： 情绪调节策略与驾驶中的努力持续行为风格的因果关系 BIPOC中的精神健康和健康发病率78.拟议的“学生崛起”项目 上述）将确定BIPOC学生谁是在面对不利条件的学术弹性，并将提供一个 量身定制的正念干预，目标是自我调节过程，作为一种假定的机制， 努力坚持的行为方式和负面健康结果之间的联系。我们建议多站点 随机试验，随机纳入504名高成就、社会经济弱势的黑人、拉丁裔和亚裔 美国学生在18所学校接受正念干预或集中注意力控制条件 关于学习技巧。本研究将：（1）测试自我调节能力的干预效果 机制（情绪抑制，经验回避，和未调制的毅力）之间。(2)测试 在治疗后12个月，BETWEVE干预对健康和心理健康结果的影响， 包括非稳态负荷的生物标志物（皮质醇、血压、体重指数、腰/臀/颈 周长），健康投诉和内化症状，（3）检查机械模型连接 在BETWEVE试验中努力保持持久的行为方式和健康结果。如果成功，这次试验将 建立一个可扩展的二级预防干预措施，有可能预防健康和精神疾病 在人口一级，BIPOC青年中服务不足的健康差距。