An investigator jointly appointed at USC and CHLA will continue her work with Filipino families to help them learn tools to prevent mental health crises among their children.

“Our grant will allow us to study interventions of positive parenting principles including active listening, taking special time to praise their child, emotional coaching, ignoring minor misbehavior, and giving and getting support, among other behaviors,” said Joyce Rivera Javier, MD, MPH, MS, FAAP, a jointly appointed Associate Professor of Clinical Pediatrics and Population and Public Health Sciences at CHLA and the Keck School of Medicine of USC.

Studies on Filipino youth have revealed higher rates of behavioral health problems such as depressive symptoms, anxiety, and substance use compared to other Asian subgroups and ethnic groups. Traditional Filipino immigrant families, however, often stigmatize those who pursue mental health solutions.

Dr. Javier tailored the Incredible Years Parent Training Program for Los Angeles families, an evidence-based, preventive parenting program for Filipino families. Her new study will focus on 250 Filipino families with children ages 8 to 12 who will participate in culturally tailored online workshops as part of the Filipino Family Health Initiative.

“We use Incredible Years as prevention model in my clinic, and we think of it as an immunization against future behavioral problems,” Javier said.

Javier learned critical research skills in the KL2 program that helped her develop a successful NIH grant proposal. The KL2 program supports career development of health professionals or individuals with research doctoral degrees who wish to pursue formal training and a career in clinical and translational research. KL2 fellows receive significant research support and mentorship from SC CTSI staff.

“I pursued a master's in clinical and biomedical translational investigations as part of my KL2 fellowship and gained understanding of methods crucial in my research, such as multivariate analysis, structural equation modeling, and health behavior theory,” Javier said.

Javier’s education in research methodology made her relationship with the Biostatistics, Epidemiology & Research Design (BERD) core at CTSI a fruitful one. She received tremendous support from BERD. For example, they analyzed her prior trial data that provided the preliminary data for her current grant and led to a publication on its own. This grant application itself—or variants of it—went through several rounds of submissions in which BERD helped with study designs, data management and data analysis plans.

Javier’s involvement in CTSI spans multiple core groups. She serves as a co-investigator within the Community Engagement group, is a member of the Workforce Development team of the SC CTSI and teaches an Introduction to Clinical Translational Research methods course. Finally, she serves as the Director of Building Up, a national program designed for postdocs and junior faculty who are underrepresented in health-related sciences.

Another CHLA researcher, Ashaunta Tumblin Anderson, MD, MPH, MSHS, FAAP is developing, implementing, and evaluating an evidence-based racial socialization intervention for young African American children. Anderson is an Assistant Professor of Clinical Pediatrics at CHLA and the Keck School of Medicine at USC.

Dr. Anderson reports that African American children disproportionately experience racism in the United States, which is associated with increased behavioral health problems and school failure. Clinic-based interventions that boost cultural pride could improve outcomes related to behavioral health and school readiness in young African American children.

Anderson will pilot and evaluate a Cultural Pride Reinforcement for Early School Readiness (CPR4ESR) intervention. This project is based on an existing program, Reach Out and Read, in which providers, usually pediatricians, give books to families who come in for their well-child checks. Anderson is introducing the cultural pride theme to Reach Out and Read for African American children ages two to four years old.

Anderson will conduct a randomized controlled trial of CPR4ESR versus Reach Out and Read among 134 African American children who will be followed for a period of 15 months.

“During a first well-child check, for example, the provider will offer a brief teaching for parents on African American children's literature,” she said. “We will talk about why cultural pride reinforcement is important, how that can help their child, and routines and rituals that they can implement in the home to support that.”

Her KL2 training award allowed her to develop research, analytic, and career development skills while working on a previous trial, preparing her for the challenges posed in her new grant.

“During Dr. Ashaunta Anderson’s time as a KL2 Scholar, we were privileged to witness her drive and conviction to develop an innovative and much needed research and career development portfolio to improve the health of African American children and their families,” said Cecilia Patino-Sutton, MD, MEd, PhD, Director of the SC CTSI Workforce Development KL2 program. “Ashaunta’s knowledge, drive, resilience, and networking skills are admirable, and she is a role model for the program. Importantly, she is kind, collaborative, thoughtful, determined and committed to the health needs of children from diverse backgrounds.”

In addition, she made use of critical resources offered within CTSI.

“Dr. Anderson initially contacted CTSI Biostatistics to provide statistical support for her KL2 application. Recognizing her enormous potential for independent research and the importance of her work, our biostatistics group has provided considerable and ongoing support to Dr. Anderson in conduct and completion of her KL2 research, as well as analysis of pilot data and study design and analysis plans for her K23 application,” said Wendy Mack, PhD, Director of the BERD core group at CTSI and Professor of Population and Public Health Sciences at USC. “We are excited to continue to provide statistical collaborations and training with Dr. Anderson to assist her development in this significant arena of health equity research.”

Ultimately, Anderson and biostatisticians from BERD submitted their results for publication. Anderson and Javier exemplify what it means to be productive physician-scientists doing meaningful work with diverse populations. Their experiences have prepared them to win more grants in the future and provide the same type of mentorship that allowed them to achieve their career goals.

“These two clinician scientists, these important and remarkable research successes, and their ongoing research programs are a result of the strong ongoing partnership between CHLA and SC CTSI,” said Tamara Simon, MD, MSPH, SC CTSI Principal Site Investigator for CHLA and pediatric hospitalist. “We are very proud their accomplishments – past, present, and future.”