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Principal Investigator: LISA J BERLIN
Organization: UNIVERSITY OF MARYLAND BALTIMORE
Fiscal Year: 2024
Award: $531,935
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Project Summary/Abstract
Latino children have worse health than non-Latino White children across many common conditions, including
respiratory illnesses and obesity, laying a foundation for health disparities across the life course. Prior studies
demonstrate that attachment-based parenting interventions, those designed to foster sensitive parenting
behavior and secure infant-parent attachment, improve maternal sensitivity, attachment security, child
socioemotional development, and some aspects of child psychophysiological regulation. To date, there has not
been a large-scale trial testing the efficacy of an attachment-based intervention for supporting physical health
more broadly. This is a significant gap, especially with regard to Latino child health promotion, given (a) the
promise of attachment-based interventions, and (b) the early origins of health disparities that negatively impact
Latino children, the largest and fastest-growing segment of the U.S. population. The proposed RCT will test
the impacts of an attachment-based intervention on emerging health outcomes in low-income Latino
children (N = 260). We will focus on low-income Latino families as a group at exceptionally high risk for health
problems. The manualized intervention, Attachment and Biobehavioral Catch-up (ABC), consists of 10
sessions provided by a trained parent coach to primary caregivers and their infants in their homes. We will
enroll families with 9-month-old infants and follow them longitudinally until age 2. In Aim 1, we will test the
effects of ABC on child health outcomes. We hypothesize positive intervention effects on common infant
and toddler illnesses (e.g., respiratory illnesses), low-grade inflammation, BMI, and sleep. In Aim 2, we will
test mediators of intervention effects. We hypothesize (a) positive intervention effects on sensitive
parenting behaviors and child stress regulation, and (b) that these factors will mediate intervention effects
on child health outcomes. In Aim 3, we will test sociocultural context as a moderator of intervention
effects. We hypothesize stronger intervention effects in higher-risk dyads (i.e., mothers who are more
acculturated, who have fewer supports, or who experience more discrimination) than in lower-risk dyads. Our
proposal is innovative in that the RCT design provides an unprecedented opportunity to test causal impacts of
an attachment-based intervention on a comprehensive set of early health outcomes known to track across the
life course. This proposal is significant in that it aligns directly with the NICHD priority of Understanding Social
Determinants of Health and Developmentally Informed Strategies to Mitigate Health Disparities. We will (a)
examine how attachment-based intervention supports a foundation for health and (b) identify subgroups to
prioritize in future efforts to optimize health in low-income Latino children.
Terms: <0-11 years old><Academy><Acculturation><Age><American><American Heart Association><BMI><BMI percentile><BMI z-score><Biological><Body mass index><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Child><Child Health><Child Rearing><Child Youth><Childhood><Children (0-21)><Cognitive Discrimination><Community Networks><Cultural Assimilation><Decrease health disparities><Development><Discrimination><Economics><Emotional><Enrollment><Environment><Face><Family><Fostering><Foundations><Future><Health><Health Promotion><Health disparity mitigation><Health disparity reduction><Home><Household><Immigrant><Infant><Inflammation><Intervention><Intervention Strategies><Investigation><Latina><Latino><Latino Population><Latino group><Latino individual><Latino people><Latinos><Life><Life Cycle><Life Cycle Stages><Low income><Lower health disparities><Manuals><Mediating><Mediator><Mitigate health disparities><Modeling><Mothers><NICHD><NIH><National Institute of Child Health and Human Development><National Institute of Children's Health and Human Development><National Institutes of Health><Nature><Obesity><Observation research><Observation study><Observational Study><Observational research><Outcome><Parenting><Parenting behavior><Parents><Pediatrics><Physiologic Psychology><Physiological Psychology><Population><Preventative intervention><Process><Psychophysiological><Psychophysiology><Quetelet index><Randomized, Controlled Trials><Reduce health disparities><Regulation><Research><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Salutogenesis><Sampling><Secure><Security><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Skin><Sleep><Sleep Deprivation><Stress><Subgroup><Testing><Toddler><United States National Institutes of Health><Work><adiposity><adolescent minority><ages><biobehavior><biobehavioral><biologic><care giving><caregiving><childrearing><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><corpulence><deficient sleep><design><designing><developmental><disparity in health><economic><efficacy testing><enroll><ethnic disparities in health><ethnic health disparity><experience><faces><facial><health disparity><high risk><homes><improved><inadequate sleep><innovate><innovation><innovative><insufficient sleep><intervention effect><intervention for prevention><interventional strategy><kids><life course><life span><lifespan><minority children><minority youth><parent><parenting education intervention><parenting education programs><parenting intervention><parenting program><parenting skill training><parenting training><pediatric><pediatric minority><physical conditioning><physical health><physiopsychology><post intervention><prevent><preventing><prevention intervention><preventional intervention strategy><preventive intervention><primary care giver><primary caregiver><promoting health><psycho-physiological><racial disparities in health><racial health disparity><randomized control trial><respiratory><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><sleep debt><sleep deficiency><sleep deficit><sleep insufficiency><sleep loss><social><social culture><social health determinants><social influence><social stresses><social stressor><socio-cultural><sociocultural><trial design><young minority><youngster>