news & updates
September 2022| Issue 7
Moving Life Course Interventions Upstream
Accelerate Upstream Together
In our Year 3 in Review, we reflected on HRSA/MCHB’s strategic paradigm “Accelerate Upstream Together”. In our spring newsletter, we focused on ways the LCIRN is working to accelerate progress on improving children's health and well-being through strategically timed interventions that aim to improve health for life.
This newsletter we’re exploring how LCIRN researchers are moving interventions “upstream” to either prevent the development of health challenges, or address and reverse them as soon as they occur. Upstream interventions are more likely to be successful than interventions that are applied only after conditions are well established.

Yet these interventions are also more challenging to design and implement because there are so many factors that contribute to the development of health challenges over long periods of time. Upstream interventions may address:

  1. Events and experiences early in life, including the sensitive pre-and peri-conception periods. Evidence suggests that certain aspects of this life stage are particularly important in setting the foundation for future health, including secure early relationships, capacity for emotional regulation and establishing healthy behaviors.
  2. Aspects of the child’s family and community environment that are not traditionally targeted by health interventions, including social and structural determinants of health,

In order to design and implement effective interventions to improve health, we need to understand 1) when and how these factors exert their influence, and 2) how to either prevent events or experiences that pose health threats from occurring, or to mitigate any potentially harmful effects once they occur.

One group who experiences significant changes in their social and cultural environments, some of which may pose challenges to their health trajectories, are migrants. Click the link below to read more about two LCIRN researchers who are working with immigrant populations to understand and improve health and well-being for migrant families across generations.
Family Webinar Series

On September 27th the LCIRN launched a new webinar series focused on families and the life course. This series will explore the central role that families play in scaffolding the health trajectories of their members. 

In the first webinar, Luke Russell, Ali Crandall, Clarissa Hoover, and Todd Jensen discussed terminology related to family conditions, processes and outcomes (e.g. family health, family functioning, family resilience): Are there accepted definitions? What terms are most useful for driving action? How do these terms support effective family-focused life course interventions?

Register for the October webinar below! The full schedule will be available on the LCIRN website as dates are confirmed.
FAMILY RESLIENCE

Wednesday, October 26, 2022
11-12 PT/2-3 ET

Dr. Froma Walsh and other presenters will explore with participants:
  • Current conceptualizations of resilience and how to promote it
  • What resilience means at a family level and how it differs from individual resilience
  • What role do resilience interventions have to play
  • What are the implications for life course interventions
Network Updates

Dr. Rebecca Dudovitz, co-leader of the School Node, received a NIDA R01: Structural racism in schools: Evaluating the impact of academic tracking and detracking on substance use and health during adolescence and the transition to adulthood.

Dr. Elizabeth Barnert received the 2022 UCLA Public Impact Research Award for her work in co-leading the Youth Justice Node, a hub for multidisciplinary leaders in youth justice to collaborate in transforming the narrative around youth who come in contact with the law towards a focus on healthy development.

The Youth Justice Node also received a contract with the California Office of Youth & Community Restoration under CalHHS to advise on youth justice reform in the state.

INRICH Workshop 2022

In June, the LCIRN co-hosted a 3-day virtual workshop with INRICH, an international group of researchers focused on child health inequalities. The theme was “Building Adaptive Interventions to Achieve Health Equity Across the Life Course.” Sessions focused on exploring shared metrics and frameworks and considering how to implement adaptive, multi-level interventions to improve health equity across the life course.
Intervention Spotlight: Family Wellbeing Program
We asked Matt Biel and Erica Coates, members of the Early Childhood Mental Health Node, to talk to us about their Family Wellbeing Program.

Overview of the intervention:
The Family Wellbeing Program was developed to expand the school based mental health model to support families attending early childhood education centers in under-resourced communities, promoting emotional and behavioral wellbeing in families, prevention of the development of mental health problems, and treating clinically significant impairment when necessary. It is a multigenerational (i.e., providing services to both caregivers and children) program that provides healing centered, evidenced-based and evidence-informed practices designed to meet the varying levels of family’s needs. The Family Wellbeing Program offers mindfulness groups and peer-led parenting groups as well as connects families experiencing clinical need with therapists.

How does this intervention go "upstream" and what is the benefit of that? Why focus on the family level?
The Family Wellbeing Program was designed to increase access to high quality, culturally relevant mental health care for a traditionally underserved population, predominantly Black caregivers with young children, by being co-located in early childhood settings and offering services to both children and caregivers due to both the importance of preventive and early interventions as well as the impact of caregivers’ mental health on children’s behaviors. Early intervention can reduce or even prevent the impact of early symptoms, and addressing contextual concerns, such as parent mental health, has been shown to mitigate child psychopathology symptoms.

What makes this a life course intervention?
The Family Wellbeing Program has many elements of life course orientation in its conceptualization including being strengths-based, longitudinally focused, multigenerational, strategically timed to intervene at the critical birth to kindergarten entry stage, multilevel (supporting families within schools in collaboration with teachers and staff), and horizontally and vertically integrated (providing services to both adults and children within trusted child serving systems).

What are the next steps?
Now that the Family Wellbeing Program has established acceptability by families and program and center staff, we are currently focused on optimizing strategies for identifying families in need of our tiered, mental health supports, enhancing communication systems between departments and programs operating at the center regarding supports and challenges experienced by center families participating in our program, and aligning and embedding our program within Head Start’s seven family outcomes to develop a sustainability plan. 
LIFE COURSE INTERVENTION RESEARCH NETWORK | lcirn.ucla.edu
This project is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under award UA6MC32492, the Life Course Intervention Research Network. The information, content, and/or conclusions are those of the author and should not be construed as the official position of, nor should any endorsements be inferred by HRSA, HHS, or the US Government. any endorsements be inferred by HRSA, HHS, or the US Government.