Mitigating Adverse Effects of COVID-19 through Preventive Interventions for Families with Young Children Living in Poverty: Linking Data from 3 Cities with Diverse Risks and Exposures

ABSTRACT Public health disasters, such as COVID-19, have disproportionate consequences on low-income and racial- ethnic minority communities through pathways that likely exacerbate disparities associated with poverty and racism, and act over extended periods. Young children are vulnerable to deleterious effects of the pandemic on psychosocial development but have received less attention and resources. Preventive interventions focused on relational health (e.g., positive and structuring parenting practices, parent-child relationship quality) have been shown to address the adverse consequences of poverty for young children. However, such interventions have yet to be tested during a public health disaster, much less one with potentially compounding effects on poverty- related and racial/ethnic disparities. The current application provides a unique opportunity to determine whether healthcare- and community-based interventions initially targeting pathways of adversity for families with young children living in poverty can prevent widening of disparities in the context of COVID-19. We propose to examine these critical issues by pooling and harmonizing seven data sets across four studies (including three NICHD R01 awards) in: 1) three very different cities (New York City, Pittsburgh, PA and Flint, MI); 2) that include low-income, Black and Latinx families; 3) involve trials of scalable preventive relational health interventions delivered in early childhood (primarily birth to 3 years), the majority with a randomized design; and 4) assess families longitudinally with multiple informants/methods to assess family socioeconomic risk, parent-child relational health, and child psychosocial development, as well as exposure and experiences linked to COVID-19, through the preschool or early school age period. Thus, the current application examines the consequences of COVID-19 for already-vulnerable families' relational health and child psychosocial development, the potential protective role of relational health interventions in attenuating emerging COVID-19- related disparities, and the variation in these effects across timing of intervention pre- and post-COVID-19 onset, experience, and exposure to the pandemic, and pre-existing family-related risk. Findings will address complex drivers of health disparities and our ability to utilize population-scalable, preventive parenting interventions to promote children's healthy psychosocial development in the context of both the COVID-19 pandemic and future public health disasters, with implications across the life course. In addition to determining the degree to which preventive interventions buffer adverse consequences on parents and children, the extensive questions that can be addressed by combining and harmonizing across these rich data sets, promise to offer the field critical information about how our most vulnerable families are faring following the pandemic. This proposal directly addresses NICHD priorities for studying "developmentally informed strategies to mitigate health disparities" of the COVID-19 pandemic on children and families.