Cindy A. Crusto, Ph.D. - US grants

DESCRIPTION (provided by applicant): The goal of this project is to test risk and resiliency pathways linking social determinants of health and child characteristics to young children's health. We will examine the role of four social determinants of health (i.e., social position, racism, segregation, and promoting/inhibiting environments) and child characteristics (i.e., trauma exposure, age, gender, temperament) on the health (i.e., social, emotional, and cognitive development and physical health) of racial/ethnic minority and/or low socioeconomic status children aged 3 through 5 years. We will carry out two specific aims. Aim 1: To test the extent to which social determinants of health and child characteristics are associated with children's health. We hypothesize that social determinants of health will have a direct and an indirect effect on young children's health. Aim 2: To test specific mediating paths and moderating effects of child characteristics on children's health. We hypothesize that (1) children's level of exposure to traumatic events will mediate the relationship between social determinants of health and children's health;(2): traumatic events related to family violence or intimate partner violence, in particular, will function as critical mediators of the relationship between the social determinants of health and children's health, and (3) child characteristics of age, gender, and temperament, will moderate the effects of social determinants of health on children's health. To test these hypotheses, we will conduct a cross sectional study in which we will collect data from a community-based sample of 400 racial/ethnic minority and/or low income children aged 3 through 5 years attending early childhood care and education settings located in an underserved urban community. Children will complete developmental assessments and their caregivers and their early childhood care and education teachers will report on children's health (i.e., social, emotional, and cognitive development and physical health). We will also use geospatial information systems to derive variables of residential segregation and promoting and inhibiting environments. The study will be conducted through collaboration between our team of university-based researchers and representatives of 13 early childhood care and education settings operated by a non-profit anti-poverty agency. PUBLIC HEALTH RELEVANCE: This project will: (1) help us to better understand the role of multiple social determinants of health and child characteristics on the health of young children;(2) help us to understand which children are at the highest risk for poor health status;and (3) inform the development and evaluation of culturally appropriate strategies at multiple levels of children's ecology to promote health. The project supports NIH's mission to conduct science to extend healthy life and reduce the burdens of illness and disability. It will further NIH's mission by fostering innovative research strategies and their application and seeks to do so for communities (geographic location, cultural groups, and young children) most at risk for poor health outcomes. The broad long-term objective is to inform a range of strategies at multiple levels of children's ecology to combat health disparities. This grant application proposes an innovative model to accelerate future scientific progress regarding the examination of multiple social determinants of health on young children's health. This project will: (1) help us to better understand the role of multiple social determinants of health and child characteristics on the health of young children;(2) help us to understand which children are at the highest risk for poor health status;and (3) inform the development and evaluation of culturally appropriate strategies at multiple levels of children's ecology to promote health.

DESCRIPTION (provided by applicant): This resubmission of a NEW INVESTIGATOR led longitudinal study is in response to (PA-11-104) and will examine: (1) the impact of (GXE) genetic and psychological environmental factors (discrimination, depression, and parenting behaviors) on the health of African American (AA) children aged 3 through 5 years and (2) the GXE risk for hypertension (HTN) in AA women and children. The overall goal of this project is to delineate the psychobiological (GXE interaction) mechanisms through which AA mothers' perceived racial discrimination, mental health, and parenting behavior affect their own and their young children's blood pressure (BP) over time. Our research will examine both genetic (candidate gene and epigenetic effects) and psychological (maternal perceived racial discrimination, mental health, and parenting behavior) interaction effects on BP on this population. We will employ a psychobiological approach by: utilizing psychological and biological assessments using a longitudinal cohort research design, a 2-step candidate gene and epigenetic methodology, and use of ancestry informative markers to account for population stratification admixture to explore GXE interactions on BP in AA mothers and children. Data analysis for the study will be conducted using multiple mixed modeling, cross-validation, and false discovery rate methods. We will enroll 250 AA children aged 3 through 5 years and their (n=250) mothers/maternal caregivers. We will assess mother and child factors every six months for 2 years. We propose the following: Aim 1: Examine the GXE interaction and epigenetic effects of mothers' perceived racial discrimination and its influence on BP over a period of two years. Aim 2: Examine the GXE interaction and epigenetic effects of mothers' mental health status [symptoms of depression] and its influence on BP over a period of two years. Aim 3: Examine the GXE interaction and epigenetic effects of mothers' parenting behavior and its influence on BP over a period of two years. Our project supports NINR's mission to promote and improve the health of individuals, families, communities, and populations by conducting basic research on the health and illness of women and young children. The proposed research extends nursing science by integrating the biological (genetics) and behavioral (psychology) components that can inform the combination of multi-level factors that contribute to AAs having the highest incidence of HTN in the US. Findings from our project can contribute to developing interventions that address genetic and psychological factors to reduce these risks for HTN.