My interest in children and families living with adversities was sparked when I volunteered to help vulnerable immigrant families. I witnessed how hardships created by immigration and poverty undermined mothers’ ability to care for their children. However, I was struck by their unceasing resilience in supporting their children amidst hardships. This experience steered the focus of my PhD program in nursing toward understanding and promoting the health of the immigrant family.

I began by conducting a scoping review that revealed substantial mental health needs in this group. To ensure that my dissertation research addressed both a scientific gap and community priorities, I used a community-based participatory research approach to interview immigrant mothers. Through this, I identified postpartum distress as a significant unmet need in this group that was rarely addressed in the literature. While a substantive theory of postpartum depression has been developed and widely used, it is culturally grounded in Western contexts. Therefore, I used the grounded theory methodology to create a new conceptual model that reflects the experiences of immigrants from non-Western contexts. With the guidance of Dr. Barbara Bowers, an internationally renowned grounded theorist, I generated a novel conceptual model that describes the socio-cultural-psychological processes through which immigrant women experience and respond to postpartum distress in the US. Through my thesis research, I gained insights into how mothers’ well-being affects their capacity to provide a positive environment that supports healthy child development.

My desire to learn strategies that strengthen parenting and parent well-being, as well as skills in quantitative methods, led me to pursue a postdoctoral fellowship at the Johns Hopkins School of Nursing with Dr. Deborah Gross. Dr. Gross is an expert in parent-child relationships and parenting interventions for families from low-income neighborhoods and the developer of the Chicago Parent Program (CPP). Under the guidance of Dr. Gross, I have directed a 2-year research project funded by the Urban Health Institute to understand how parents’ adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) are associated with CPP participation and benefits. We found that a universal trauma-informed parenting program like CPP offered in public schools in high-poverty urban communities can engage parents exposed to high levels of ACEs. Importantly parents exposed to high levels of ACEs also have many PCEs which could be a source of resilience.

In parallel, I led an international collaborative survey project that examined the prevalence and patterns of ACEs and PCEs and their association with well-being among a national sample (>10,000) of Chinese young adults. We focused on young adults as they are at the life stage when most people become parents. We found that PCEs are associated with adult flourishing (including physical and mental health), even among individuals exposed to high levels of ACEs. Importantly, we found that about 1 in 3 reported emotional neglect and only about half reported being able to talk to family about feelings growing up in our sample.

Through my prior training, I have developed expertise on the behavioral pathways through which parents pass adversity or resilience on to their children (e.g., parenting and parent mental health). Recognizing that early adversity can be biologically embedded and transmitted intergenerationally, with the support of a stellar committee members (Drs. Sara Johnson, Mary Dozier, Steve Cole, Deborah Gross, Xiaobing Wang), I secured the K99/R00 award from NICHD to integrate biological pathways (particularly immunologic and genomic) into my analyses of intergenerational transmission of health risk and resilience. The goal of this K99/R00 study is to elucidate the relationships among mothers' ACEs and PCEs, maternal sensitivity, and immune regulation in infants (K99 phase, 6 months) and toddlers (R00 phase, 12, 24, 36 months) of mothers who are living with opioid dependence, a high-risk group that often encounters a host of adversities. This K99/R00 study builds on and extends a NICHD-funded randomized clinical trial (R01HD098525) that tests the efficacy of a parenting intervention, the Attachment and Biobehavioral Catch-up (ABC), among mothers with opioid dependence and infants with perinatal opioid exposure.

I have expanded my knowledge and skills in assessing immune biomarkers and intervention research through the proposed training and research during the K99 phase, which has built a strong foundation for the R00 phase and facilitated my transition to independence. Guided by the established Conserved Transcriptional Response to Adversity genomic framework, the R00 phase aims to determine how mothers' ACEs and PCEs are associated with toddlers' immune regulation as indicated by both cellular (salivary CRP and sIgA) and transcriptomic (immune cell gene expression profile) biomarkers; this will be accomplished by prospectively following at least 80 toddlers enrolled in the parent study at ages 12, 24, and 36 months.