ACHiP-ACEs and Cardiometabolic Health in Pediatrics: Using a Coping and Stress Reduction Intervention to Reduce Cardiometabolic Risk in Adolescents with Adversity

项目摘要/摘要 候选人：Nia Hed-Garris，医学博士，理学硕士，儿科医生，初级临床研究员，专注于 研究青少年心脏代谢健康(CMH)的社会风险因素，降低青少年心脏代谢健康的风险 心脏代谢性疾病的发展。希尔德-加里斯博士的长期职业目标是开发有效的 对青少年的干预措施，以减轻儿童逆境对儿童健康的负面影响 寿命。拟议的培训和研究活动将有力地支持希尔德-加里斯博士成为 独立的医生-调查员，研究和解决青少年CMH的社会风险因素。 研究背景：近3400万美国儿童经历一次或多次不良童年经历 (A)到18岁。A导致生理和行为变化，减少应对和增加压力， 使成年人易患心脏代谢性疾病。然而，ACEs对青春期CMH的影响 目前尚不清楚，降低ACE相关CMH风险的干预策略也不发达。 青春期是一个理想的检查时期，以确定与CMH和发展最密切相关的ACE 在青少年进入成年期之前，中断ACES-CMH途径的干预。 具体目标：1)确定ACE、CMH相关行为和CMH之间的关系 青少年；2)对患有ACEs的青少年采取应对和减压(Cedars)干预措施 儿科临床环境；3)试点适应的雪松，在临床环境中为暴露于ACE的青少年量身定做。 研究计划：为了实现这些目标，希尔德-加里斯博士将从以下方面收集ACE和CMH数据 并进行分析，以更好地描述ACES-CMH途径；使雪松成为 通过焦点小组在临床环境中使用；以及实施和评估雪松。 职业发展计划：希尔德-加里斯博士将学会整合医学和社会科学的方法 研究ACES和CMH的方法。她将获得青少年CMH方面的专业知识并发展能力 在积极情绪、减压干预方面。希尔德-加里斯博士将拓宽她的专业技能。Dr。 希尔德-加里斯的职业发展目标将得到一个跨学科核心指导团队的良好支持； 专家咨询小组的指导；体验式实验室沉浸；高级教学课程作业； 参加专业会议；参加研讨会；执行她的研究计划。这 培训将直接有助于她设计有效的干预措施，解决高危人群的CMH问题。 青少年，以及随后成功提交的R34临床试验计划赠款和R01。 环境：希尔德-加里斯博士有一个由美国国立卫生研究院资助的核心导师和顾问团队，他们致力于 指导她走向独立。她得到了西北大学和鲁里儿童医院的支持， 两者都拥有出色的研究基础设施，并坚定地致力于支持初级调查人员。

PROJECT SUMMARY/ABSTRACT Candidate: Nia Heard-Garris, MD, MSc is a pediatric physician and a junior clinical investigator focused on examining the social risk factors of adolescent cardiometabolic health (CMH) and reducing the risk of the development of cardiometabolic disease. Dr. Heard-Garris’s long-term career objective is to develop effective interventions for adolescents that mitigate the negative influence of childhood adversity on CMH throughout the lifespan. The training and research activities proposed will strongly support Dr. Heard-Garris in becoming an independent physician-investigator examining and addressing the social risk factors of CMH in adolescents. Research Context: Nearly 34 million US children experience one or more adverse childhood experiences (ACEs) by age 18. ACEs drive physiological and behavioral changes, reduced coping and increased stress, predisposing adults to cardiometabolic disease. However, the influence of ACEs on CMH in adolescence remains unclear, and intervention strategies to reduce ACEs-related CMH risk are underdeveloped. Adolescence is an ideal time to examine to identify the ACEs most strongly associated with CMH and develop interventions to interrupt the ACEs-CMH pathway, before adolescents transition into adulthood. Specific Aims: 1) Determine the relationship between ACEs, CMH-related behaviors, and CMH in adolescents; 2) Adapt a Coping and Stress Reduction (CEDARS) intervention for adolescents with ACEs in a pediatric clinic setting; 3) Pilot the adapted CEDARS, tailored to ACE-exposed adolescents in a clinical setting. Research Plan: To accomplish these aims, Dr. Heard-Garris will collect ACEs and CMH data from adolescents and conduct analyses to better characterize the ACEs-CMH pathway; adapt the CEDARS to be used within a clinical setting through focus groups; and implement, and evaluate the CEDARS. Career Development Plan: Dr. Heard-Garris will learn to integrate medical and social science methodological approaches to study ACEs and CMH. She will acquire expertise in adolescent CMH and develop competency in positive-emotion, stress-reduction interventions. Dr. Heard-Garris will broaden her professional skills. Dr. Heard-Garris’s career development goals will be well-supported by an interdisciplinary core mentorship team; guidance from an expert advisory panel; experiential lab immersions; advanced didactic course work; attendance at professional meetings; participation in seminars; and implementation of her research plan. This training will directly contribute to her goal of designing effective interventions that address CMH in at-risk adolescents, as well as the subsequent submission of a successful R34 clinical trial planning grant and R01. Environment: Dr. Heard-Garris has a NIH-funded core mentorship and advisory team who are dedicated to mentoring her to independence. She is supported by Northwestern University and Lurie Children’s Hospital, both with outstanding research infrastructures and strong commitments to supporting junior investigators.