Effects of Neighborhood Environment on Child Behavioral Health

摘要。健康的儿童发展对长期健康至关重要，因为它使人类的能力 参与经济、社会和公民生活;然而，并非所有儿童都能健康发展。许多 儿童受到健康的社会决定因素（SDOH）的影响，包括由于其 邻里环境。邻里环境，一个强大的SDOH，深刻地塑造了儿童的 身体、心理和情绪健康，并影响儿童实现长期健康的机会。 居住在贫困社区的父母也往往会遇到无效的应对，养育子女的挑战， 和次优的家庭凝聚力，这可能会影响行为失调和学习成绩， 童年早期行为失调-自我调节行为的能力受损，其特征是 自反性的，自动的，情绪化的行为反应-与共同的发展有关。 儿童精神病理学此外，行为失调与学业不良有关。 这是儿童长期健康的另一个重要指标。在儿童早期研究这些结果 提供了机会之窗，以找到促进终身健康和缩小健康差距的解决办法 生活中的差异。养育行为和家庭凝聚力（家庭成员之间的积极关系） 亲密程度、情感纽带和支持）是家庭关系的可变指标， 可以有针对性地减轻邻里环境对儿童行为失调的影响。在这 NRSA F31提案，使用环境对儿童健康影响的丰富公开数据 结果（ECHO）计划，我将采用创造培育环境框架来解决以下问题 具体目标：1）确定邻里环境对行为失调和学业的影响 儿童早期（1-6岁）的表现; 2）确定家庭关系在多大程度上介导 邻里环境对行为失调和学习成绩的影响所附 职业发展计划将为我奠定基础，a）建立儿童发展方面的专业知识， 强调行为健康和学习成绩; B）建立邻里环境的专业知识， c）提高数据分析的定量研究方法技能，如结构分析、 方程建模; d）获得团队科学技能的经验，并完成专业发展目标。 我有一个强大的导师团队，他们在各自的领域有影响力，拥有强大的NIH资金， 出版物，致力于我的成长和发展，在这个F31奖和我的职业生涯。职业 发展和研究计划将指导我实现我的最终职业目标，成为一个独立的 护士科学家谁推进科学解决SDOH和促进儿童健康。该提案与 新的NINR战略计划，其重点是了解SDOH，以促进社区的健康公平 具有共同的优势和弱点。

ABSTRACT. Healthy child development is essential to long-term wellness because it enables human capacity to participate in economic, social, and civic life; however, not all children experience healthy development. Many children are affected by social determinants of health (SDOH) including structural inequities resulting from their neighborhood environment. Neighborhood environment, a powerful SDOH, profoundly shapes children's physical, mental, and emotional health, and influences opportunities for children to achieve long-term health. Parents who reside in poorer neighborhoods also tend to experience ineffective coping, parenting challenges, and suboptimal family cohesion, which may influence behavioral dysregulation and academic performance in early childhood. Behavioral dysregulation – an impairment in ability to self-regulate behaviors characterized by reflexive, automatic, and emotional reaction of acting out – is associated with the development of common childhood psychopathologies. In addition, behavioral dysregulation is associated with poor academic performance, another important indicator of long-term child health. Studying these outcomes in early childhood provides windows of opportunity to find solutions to promote life-long health and close the gap on health disparities later in life. Parenting behavior and family cohesion (positive relationships between family members and the level of closeness, emotional bonding, and support) are modifiable indicators of family relationships that can be targeted to mitigate the effect of neighborhood environment on child behavioral dysregulation. In this NRSA F31 proposal, using rich publicly available data from the Environmental Influences on Child Health Outcomes (ECHO) Program, I will adopt the Creating Nurturing Environments framework to address the following specific aims: 1) Identify the effect of neighborhood environment on behavioral dysregulation and academic performance in early childhood (1-6 years); 2) Determine the degree to which family relationships mediate the effect of neighborhood environment on behavioral dysregulation and academic performance. The accompanying career development plan will build the foundation for me to a) Build expertise in child development with emphasis on behavioral health and academic performance; b) Build expertise in neighborhood environment and its effect on child health; c) Advance skills in quantitative research methods for data analysis such as structural equation modeling; d) Gain experience in team science skills and accomplish professional development goals. I have a strong mentorship team who are influential in their respective fields with robust NIH-funding and publications, dedicated to my growth and development throughout this F31 award and my career. The career development and research plan will guide me to achieve my ultimate career goal of becoming an independent nurse scientist who advances the science in addressing SDOH and promoting child health. This proposal aligns with the new NINR Strategic Plan with its focus to understand SDOH to promote health equity in neighborhoods with shared characteristics of strengths and vulnerabilities.