Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Poverty, Racism, and the COVID-19 Pandemic

摘要 早期成年人正在经历高比例的心理健康问题，包括焦虑，抑郁，自杀， 精神病NIMH资助的R 01早期步骤多站点父母补助金的总体目标是检查 随机化对2 - 10岁儿童是否接受家庭检查（FCU）的影响 从幼儿期到成年早期的发展途径，重点关注心理健康障碍， 成人初显期的精神病学。与早期步骤父母补助金的第三个目标相一致，“审查 FCU对心理健康的长期预防作用，在贫困中成长的背景下，“这 《补编》建议扩大这一目标，特别侧重于生活在贫困中的各个方面， 幼儿期（照顾者的收入、就业、教育和经济压力）作为独立的贡献者 青少年和成年早期自我报告的心理健康风险，如果这些 关系是由母亲的抑郁和照顾者的能力在儿童时期介导的，并调节 FCU的干预。我们还计划用精神卫生保健利用率来检查这个模型，对于那些 经历心理健康问题，在青春期和成年期作为结果。这项研究的结果将 有助于理解在贫困中成长的具体方面如何可能加剧或改善 青少年和成年期的心理健康咨询学，以及FCU如何缓冲 儿童期贫困对后期心理健康和心理卫生保健利用的影响。总的来说，研究和 Chirimwami博士将接受的培训作为这种多样性补充的一部分，将加速他向 独立研究科学家通过扩大他在儿童贫困方面的专业知识， 社区，FCU干预的影响，纵向建模，以及学术和赠款写作。

ABSTRACT Early adults are experiencing high rates of mental health issues, including anxiety, depression, suicidality, and psychosis. The overall goal of the NIMH-funded R01 Early Steps Multisite parent grant is to examine the impact of randomization to receipt of the Family Check-Up (FCU), or not, from child ages 2 to 10 on developmental pathways from early childhood to early adulthood, focusing on mental health disorders and symptomatology in emerging adults. Aligned with the third aim of the Early Steps parent grant, “to examine the long-term preventive effects of the FCU on mental health, in the context of growing up in poverty,” this supplement proposes an extension of this aim, specifically focusing on various aspects of living in poverty in early childhood (caregiver income, employment, education, and financial stress) as independent contributors to risk for self-reported mental health symptomology in adolescence and early adulthood, and if these relationships are mediated by maternal depression and caregiver competence in childhood, and moderated by the FCU intervention. We also plan to examine this model with mental health care utilization, for those experiencing mental health issues, in adolescence and adulthood as the outcome. Findings from this study will contribute to understanding of how specific aspects of growing up in poverty may exacerbate or ameliorate mental health symptomatology in adolescence and adulthood, and how the FCU may buffer the impact of childhood poverty on later mental health and utilization of mental health care. Overall, the research and training Dr. Chirimwami will receive as part of this diversity supplement will accelerate his transition to an independent research scientist by expanding his expertise in childhood poverty, work with underserved communities, the impact of the FCU intervention, longitudinal modeling, and scholarly and grant writing.