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

项目总结 边缘化社区的学生，他们努力摆脱逆境，取得学业成功 被认为是“有弹性的”。然而，年轻人在一个领域(即学术领域)的韧性可能会以 其他领域，包括未得到充分认识和治疗的身心健康疾病。 先前的研究表明，黑人、土著和有色人种(BIPOC)表现出一种 坚持不懈的行为风格“在面对逆境时表现出后来的健康病症。讽刺的是，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 损害健康和心理健康的调节失调1-3.涉及情绪的自我调节过程 压抑、经验回避和无节制的毅力可以在不平衡负荷中达到顶峰 加剧健康差异1，4并内化抑郁和焦虑的症状5。 拟议的机械性试验将利用正念训练来允许检查以下问题 情绪调节策略与驾驶中奋力坚持行为风格的因果关系 BIPOC78的心理健康和健康发病率。拟议的项目奋力(学生崛起 以上)将确定在面对劣势时在学业上有韧性的BIPOC学生，并将提供 以自我调节过程为目标的量身定制的正念干预作为一种假定的机制来中断 努力持之以恒的行为方式与消极的健康后果之间的联系。我们提出了一个多站点 对504名成就卓著、社会经济条件较差的黑人、拉丁裔和亚洲人进行的随机试验 18所学校的美国学生接受正念干预或集中注意力控制条件 在学习技巧上。本研究将：(1)检验努力干预对假设的自我调节的影响 他们之间的机制(情绪抑制、经验回避和不受约束的毅力)。(2)测试 努力干预对治疗12个月后健康和心理健康结局的影响 包括平衡负荷的生物标志物(皮质醇、血压、体重指数、腰围/臀围/颈部 周长)、健康抱怨和内在化症状，以及(3)检验链接的机制模型 在奋进试验中努力保持持久的行为方式和健康结果。如果成功，这场审判将 建立一种可扩展的二级预防干预措施，有可能预防健康和精神疾病 在人口层面，服务不足的BIPOC青年之间的健康差距。

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.