The impact of stress and caregiver sensitivity on infant cellular aging in a population of under-resourced families: A randomized controlled trial.

Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. MODIFIED TITLE: The impact of early experiences and parent sensitivity on infant cellular aging: A randomized controlled trial. Modified Project Summary The aim of the proposed randomized controlled trial (RCT) is to test if an evidence-based home visiting model, Promoting First Relationships® (PFR), that improves parents’ sensitive and responsive care, will protect young infants from the effect of accelerated cellular aging. During the first years of life, children are particularly susceptible to the impact of early life experiences that shape long term health outcomes and overall aging. One mechanism that has not yet received systematic exploration in young children, in the context of a randomized control trial (RCT), is the study of telomere length and epigenetic age clocks. Both telomere length and epigenetic aging clocks are unique markers of cellular aging, including pediatric samples. Cellular aging is a marker of early disease process. This RCT will provide a home visiting program hypothesized to buffer cellular aging in a pediatric sample of children under the age of one. The setting for this study is unique. We have partnered with WakeMed primary care in North Carolina, a busy pediatric practice that utilizes an integrated care model. We will recruit a sample of 250 parents and their infants receiving supportive primary care from WakeMed. Parents will be randomized to Usual Care or to PFR-in Primary Care (PFR-PC), a 10-week home visiting program with follow-up PFR-PC content during well-child visits. We will measure parents’ telomere length at baseline and child’s telomere length and epigenetic age clocks at baseline and one-year post-intervention. Aim 1 will evaluate three under-studied heritability and intergenerational predictors of cellular aging in young children, namely parental telomere length at baseline (i.e. heritability), parental childhood experiences, and parental age at conception (i.e., intergenerational factors). Aim 2 will evaluate the impact of early life experience on changes in cellular aging. We will test if current parental experiences predict child cellular aging between baseline and 12-months post-intervention, controlling for heritability and intergenerational effects. Aim 3 will test whether PFR-PC reduces accelerated cellular aging and improves parenting sensitivity and child outcomes one-year later. Finally, an exploratory aim will evaluate PFR-PC implementation (dosage, quality, acceptability, satisfaction, and provider fidelity). The current proposal moves the integrated care model one step further. Early interventions are key approaches to addressing health outcomes, especially when integrated into primary care settings that are low cost, disseminatable, and grounded in strong theoretical premises related to cellular aging.