A Pilot Study to Address Intergenerational Health Impacts of Childhood Trauma
We are excited to announce a new project that will pilot test a three module intervention to holistically address the mental and physical health of postpartum women and their children. The pilot study will build on three existing interventions, first addressing mothers’ adverse childhood experiences (ACEs), second supporting positive parent-child relationships and lastly promoting the adoption of healthy diet and physical activity behaviors. We plan to recruit a racially and ethnically diverse cohort of 100 postpartum women in the Atlanta metro area attending their postpartum visit (~12 weeks following delivery) at a local Emory clinic and randomly allocate them to our integrated intervention or a usual care model. We will follow mother-child pairs longitudinally for 6 months postpartum to assess the mental and physical health impact of the intervention on both mothers and children. Specifically, this project will allow us to conduct a randomized control trial (RCT) to evaluate the socio-emotional well-being of mothers and young children at 6 and 12 months. We will furthermore evaluate cardiovascular health and behaviors of mothers and their young children. The pilot study will allow us to examine how social, environmental and behavioral factors modulate biological systems to maintain health and promote resilience. Our goal is to determine the feasibility of this intervention and develop a larger study to test the impact of this intervention on maternal and child health outcomes. This work has the potential to inform primary and secondary prevention of the negative physical and mental effects of trauma by demonstrating how a trauma-prevention and parenting intervention can be integrated into a postpartum clinic serving a diverse, high-risk patient population. We are grateful to the Biology of Trauma Initiative at the Broad Institute of MIT and Harvard which provides funding support for this project.
We Are Recruiting 3-4 Month Postpartum Women Who Received Care at Emory: Click here to participate by completing our form!
Childhood Adversity and Cardiovascular Health among Puerto Rican Youth
Latinos, are vulnerable to the health related consequences of living in poverty; 32% are obese and 22% have hypertension. Puerto Rican women have the highest rate of obesity, hypertension and hypercholesterolemia than any other Latino subgroup. Recent research has demonstrated that childhood adversity is associated with cardiovascular disease in adulthood. However, adapting and coping behaviors that prime those exposed to adversity in childhood to develop poor cardiovascular outcomes remain largely unexplored. The Boricua Youth Study (BYS) Health Assessment (HA) aims to understand how childhood adversity affects obesity, blood pressure and inflammation as well as potential modifiers and mediators of these associations in a young adult cohort, prior to the development of cardiovascular disease. The study is conducting a cardiovascular health assessment of Puerto Rican young adults (ages 18-23) part of the BYS longitudinal study, living in two different contexts: the South Bronx, NY and San Juan, Puerto Rico. In this unique sample of a homogeneous Latino subgroup (Puerto Ricans) in two contexts, we propose to examine: 1) the relation between childhood adversity (negative life events, parental incarceration, psychopathology and substance use, child maltreatment) and selected indicators of cardiovascular heath (obesity, blood pressure and systemic inflammation) in young adulthood; 2) the mediating effect of child mental and substance use disorders; and 3) the role played by socio-cultural factors, including context, social support, acculturation and use of health services.
Stress Epigenetics and Aging
There is extensive evidence that socioeconomic status (SES) and social stressors shape the development of numerous chronic conditions and aging-related illnesses. However, the processes through which SES and social stress affect biological processes related to aging and disease development have not been fully elucidated, particularly at the cellular level. Research examining associations between stressors and biological aging processes have been predominately cross- sectional in nature and have included predominately racially and ethnically homogenous samples. We leverage existing data from the Disparities (DISPAR) study, part of the CHDS study, to examine the relationship between stressors and resilience across the life course in relation to biological aging processes. The DISPAR study conducted a 50-year follow-up of women who participated in the CHDS pregnancy cohort between 1959 and 1957 in Alameda County, California. Subsets of offspring were followed at ages 5 y, 9-11 y and 15-17y. The DISPAR sample includes a representative subsample of these children interviewed as adults (mean age 50y). In this unique cohort we examine the role of childhood and adult SES and psychosocial stressors (e.g. child adversity, caregiving stress, job stress, racial discrimination) on telomere length and methylation age in adulthood. Additionally, we will examine behavioral (e.g. physical activity, smoking) and psychological (e.g. distress) responses to stress as potential mediators of these associations, and positive and negative coping factors as potential modifiers of the associations between SES, stress and biological processes. Given that half of the sample is African-American, we will have the opportunity to assess how stress, resilience-based factors, and associated biological aging processes differ by race. Completion of this project would allow us to elucidate important biological, genetic, and epigenetic pathways that help explain how stress and resilience shapes population health disparities among aging populations.
Social Stress Epigenetics and Cardiometabolic Health Among Latinos
Within this ancillary study to the Hispanic Community Health Study /Study of Latinos (HCHS/SOL) we will examine the association between social and economic stressors across the life course in relation to DNA methylation, as well as the rate of change of methylation and changes in cardiometabolic health. The HCHS/SOL study is a longitudinal study of US Latinos, representing varied countries of origin, conducted in the US. We propose to use existing data from a random sample of men and women, who completed an extensive set of socio-economic and stress measures in the HCHS/SOL Sociocultural Ancillary study and who provided blood samples at two different time points six years apart in adulthood. Existing blood samples will be assayed for genome-wide DNAm and DNAm age. Cardiometabolic health markers (obesity, diabetes, hypertension and lipids) have also been assessed at two time points. Existing data also includes repeated assessments of social and economic stressors and socio-cultural factors (i.e., nativity, familism, acculturation, social support). Specifically, we will examine 1) whether social and economic stressors in childhood and adulthood are associated with changes in DNAm age and genome-wide methylation over a 6-year period; 2) whether sociocultural factors modify the association between stressors and changes in DNAm and 3) whether DNAm is associated with changes in cardiometabolic health over a 6-year period. Upon completion of this project, our findings will advance understanding of how social and economic stressors shape epigenetic pathways, what factors may exacerbate or ameliorate these pathways and whether epigenetic changes over time influence cardiometabolic health changes.