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Enhancing Early Relational Health to Reduce Disparities in Child Health and Development: Addressing ACEs and Promoting PCEs through an Integrated Evidence-based Intervention in Pediatric Primary Care

Award Number: R01MD018597
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/25/2023
PERIOD OF PERFORMANCE END DATE: 02/29/2028

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Enhancing Early Relational Health to Reduce Disparities in Child Health and Development: Addressing ACEs and Promoting PCEs through an Integrated Evidence-based Intervention in Pediatric Primary Care - Poverty is linked to disparities in early child development (ECD), including school readiness (pre-academic skills, self-regulation, social-emotional well-being), which are a core contributor to long-term health and mental health outcomes. These disparities begin early in life, widen as children age, and persist across the lifespan. Poverty also increases the likelihood of adverse childhood experiences (ACEs) and decreases the likelihood of positive childhood experiences (PCEs). Importantly, PCEs are not simply the absence of ACEs; they are factors that are beneficial for children’s development and may be especially important in providing a buffer for the impacts of ACEs. Two interrelated frameworks (Stress and Investment) illustrate how ACEs and PCEs impact ECD through a key common pathway of early relational health (ERH; parent-child relationship quality, structuring the home environment, responsivity/cognitive stimulation). Thus, enhancing ERH by both addressing ACEs and promoting PCEs is critical for mitigating disparities in ECD. Evidence-based preventive interventions (EBPIs) designed to reduce these disparities have increasingly been located in pediatric primary care due to its population-level reach, frequent visits, trusted relationships, and potential for low cost. However, few EBPIs have successfully integrated strategies to concurrently and directly address ACEs and promote PCEs, limiting their capacity to fully address disparities in ECD synergistically. Moreover, knowledge gaps related to dissemination and implementation (D&I) of integrated EBPIs represent a key barrier to improving implementation effectiveness and impact. We propose a novel integration of HealthySteps (HS) and PlayReadVIP, two exemplar, American Academy of Pediatrics (AAP)-recommended EBPIs. HS provides a stepped-care approach with universal screening for ACEs and additional support and referrals for families with increased concerns. HS has been shown to reduce family vulnerabilities and negative relationship quality elements of ERH. However, HS has limited impact on PCEs, suggesting additional strategies may be needed to improve effectiveness of the HS stepped-care approach in enhancing ERH. Integrating PlayReadVIP may address this gap with its focus on video-recording parents and children interacting with a toy or book provided by the program and real-time, strengths-based feedback, which has impacts on parenting assets and responsivity/cognitive stimulation elements of ERH. We will test an integrated HS+VIP model in order to: 1) identify best practice strategies for implementing integrated EBPIs in pediatric care sites; 2) examine effectiveness and implementation outcomes of the HS+VIP model; and 3) examine mechanisms underlying these outcomes. This integrated model has the potential for population-level reductions in disparities in ECD outcomes by targeting ACEs and PCEs simultaneously and will provide strong support for developing best practices for the D&I of such models.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $833,002 )
2026	2026	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	4	2/8/2026	NON-COMPETING CONTINUATION	$749,702
2026	2026	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	4	2/21/2026	NON-COMPETING CONTINUATION	$83,300
														Subtotal = $833,002

Issue Date FY: 2025 ( Subtotal = $833,002 )
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	003	3	9/19/2025	NON-COMPETING CONTINUATION	$0
2025	2025	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	3	8/5/2025	NON-COMPETING CONTINUATION	$833,002
2025	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	2	2/25/2025	NON-COMPETING CONTINUATION	$0
2025	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	002	2	9/19/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $833,002

Issue Date FY: 2024 ( Subtotal = $832,999 )
2024	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	2	2/11/2024	NON-COMPETING CONTINUATION	$749,700
2024	2024	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	2	6/5/2024	NON-COMPETING CONTINUATION	$83,299
														Subtotal = $832,999

Issue Date FY: 2023 ( Subtotal = $850,382 )
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	001	1	9/2/2023	NEW	$0
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Minority Health and Health Disparities Research	000	1	8/25/2023	NEW	$850,382
														Subtotal = $850,382

Grand Total All Awards = $3,349,385

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Enhancing Early Relational Health to Reduce Disparities in Child Health and Development: Addressing ACEs and Promoting PCEs through an Integrated Evidence-based Intervention in Pediatric Primary Care

Award Number: R01MD018597

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/25/2023

PERIOD OF PERFORMANCE END DATE: 02/29/2028

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