Mitigating Adverse Effects of COVID-19 through Preventive Interventions for Families with Young Children Living in Poverty: Linking Data from 3 Cities with Diverse Risks and Exposures

摘要 新冠肺炎等公共卫生灾难对低收入者和种族歧视人群造成了不成比例的后果 少数民族社区通过可能加剧与贫困和 种族主义，并在较长时期内采取行动。幼儿很容易受到流感大流行的有害影响。 心理社会发展，但受到的关注和资源较少。预防性干预的重点是 关系健康(例如，积极和结构化的育儿做法、亲子关系质量)一直是 显示了解决贫困对幼儿的不利后果的能力。然而，这种干预已经 尚未在公共卫生灾难期间进行测试，更不用说对贫困产生潜在复杂影响的灾难了- 相关的和种族/民族差异。当前的应用提供了一个独特的机会来确定 以医疗保健和社区为基础的干预措施最初是否针对家庭的逆境途径 在新冠肺炎的背景下，解决儿童贫困问题可以防止贫富差距扩大。 我们建议通过汇集和协调四项研究中的七个数据集来检查这些关键问题 (包括三个NICHD R01奖)在：1)三个非常不同的城市(纽约市、匹兹堡、宾夕法尼亚州和弗林特， MI)；2)包括低收入、黑人和拉丁裔家庭；3)涉及可扩展的预防性关系试验 在儿童早期(主要是出生到3岁)提供的卫生干预措施，大多数是随机进行的 设计；以及4)纵向评估家庭，采用多种信息来源/方法评估家庭的社会经济状况 风险、亲子关系健康、儿童心理社会发展以及接触和经历 链接到新冠肺炎，通过学龄前或早期学龄期。因此，当前应用程序检查 新冠肺炎对本已脆弱家庭的关系健康和儿童心理社会的影响 发展，关系卫生干预在削弱新兴新冠肺炎方面的潜在保护作用- 新冠肺炎干预前后的相关差异以及这些影响在干预时机上的变化 发病、经历和接触大流行，以及先前存在的与家庭相关的风险。 这些发现将解决健康差距的复杂驱动因素，以及我们利用人口可扩展、 预防性育儿干预措施，以促进儿童健康的心理社会发展 新冠肺炎大流行和未来的公共卫生灾难，影响到整个生命过程。在……里面 除了确定预防性干预在多大程度上缓解了父母的不良后果 和孩子们，广泛的问题可以通过合并和协调这些富人来解决 数据集，承诺向现场提供关于我们最脆弱的家庭情况的关键信息 在大流行之后。这项建议直接涉及NICHD研究的优先事项 新冠肺炎大流行对儿童和家庭的影响：“采取明智的战略缩小健康差距”。

ABSTRACT Public health disasters, such as COVID-19, have disproportionate consequences on low-income and racial- ethnic minority communities through pathways that likely exacerbate disparities associated with poverty and racism, and act over extended periods. Young children are vulnerable to deleterious effects of the pandemic on psychosocial development but have received less attention and resources. Preventive interventions focused on relational health (e.g., positive and structuring parenting practices, parent-child relationship quality) have been shown to address the adverse consequences of poverty for young children. However, such interventions have yet to be tested during a public health disaster, much less one with potentially compounding effects on poverty- related and racial/ethnic disparities. The current application provides a unique opportunity to determine whether healthcare- and community-based interventions initially targeting pathways of adversity for families with young children living in poverty can prevent widening of disparities in the context of COVID-19. We propose to examine these critical issues by pooling and harmonizing seven data sets across four studies (including three NICHD R01 awards) in: 1) three very different cities (New York City, Pittsburgh, PA and Flint, MI); 2) that include low-income, Black and Latinx families; 3) involve trials of scalable preventive relational health interventions delivered in early childhood (primarily birth to 3 years), the majority with a randomized design; and 4) assess families longitudinally with multiple informants/methods to assess family socioeconomic risk, parent-child relational health, and child psychosocial development, as well as exposure and experiences linked to COVID-19, through the preschool or early school age period. Thus, the current application examines the consequences of COVID-19 for already-vulnerable families’ relational health and child psychosocial development, the potential protective role of relational health interventions in attenuating emerging COVID-19- related disparities, and the variation in these effects across timing of intervention pre- and post-COVID-19 onset, experience, and exposure to the pandemic, and pre-existing family-related risk. Findings will address complex drivers of health disparities and our ability to utilize population-scalable, preventive parenting interventions to promote children’s healthy psychosocial development in the context of both the COVID-19 pandemic and future public health disasters, with implications across the life course. In addition to determining the degree to which preventive interventions buffer adverse consequences on parents and children, the extensive questions that can be addressed by combining and harmonizing across these rich data sets, promise to offer the field critical information about how our most vulnerable families are faring following the pandemic. This proposal directly addresses NICHD priorities for studying “developmentally informed strategies to mitigate health disparities” of the COVID-19 pandemic on children and families.