Precision Medicine Researcher-Community Collaborations Awarded $9 Million to Address Adverse Childhood Experiences

March 30, 2021 - The Governor's Office of Planning and Research, in partnership with the Office of the CA Surgeon General, is pleased to announce four awardees for the California Initiative to Advance Precision Medicine request for proposals, Addressing Health Impacts of Adverse Childhood Experiences through a Collaborative Precision Medicine Approach.

Precision medicine holds promise to more fully apply data to improve health and health care. Nine million dollars in state funds will support proof-of-principle demonstration projects for families and communities with Adverse Childhood Experiences (ACEs) with an aim to improve access, care, and outcomes through collaboration between academic, community, nonprofit, and private partners. Each team is awarded $2-2.4 million over a three-year timeline, beginning May 2021.

The four awardees are:

  • Children's Hospital Los Angeles: "Scalable Measurement and Clinical Deployment of Mitochondrial Biomarkers of Toxic Stress."
  • Loma Linda University: "A Multi-Component Intervention to Strengthen Families and Build Youth Resilience."
  • University of California, Irvine: "Using Precision Medicine to Tackle Impacts of Adverse and Unpredictable Experiences on Children's Neurodevelopment."
  • University of California, San Francisco: "The Collaborative approach to examining Adversity and building Resilience (CARE) Program."

Awardees

Children's Hospital Los Angeles

"Scalable Measurement and Clinical Deployment of Mitochondrial Biomarkers of Toxic Stress."

Summary

The very best outcomes will be achieved by identifying infants at greatest risk for ACEs and toxic stress and intervening to reduce the chronic stress response. This project will improve early screening by combining a questionnaire with innovative laboratory tests that detect disruptions in metabolic health, a key indicator of toxic stress. The collaboration between experts in precision medicine, laboratory test development, child development, stress-related health risks, and health equity improvement will bring a greater understanding of infant-caregiver well-being, and—through screening—close the equity gap in access to quality behavioral health programs.

Project Team

Lead Principal Investigator
  • Pat Levitt, PhD, Chief Scientific Officer, Vice President, and Director, The Saban Research Institute; Simms/Mann Chair in Developmental Neurogenetics, Children's Hospital Los Angeles; WM Keck Provost Professor in Neurogenetics, Department of Pediatrics, Keck School of Medicine, University of Southern California
Principal Investigator
  • Rajan Sonik, PhD, JD, MPH, Institute for Health Equity, AltaMed Health Services
Key Partners, Collaborators, and Supporters
  • Children's Hospital Los Angeles
    • Xiaowu Gai, PhD, Faculty Co-Investigator
    • Alma Gharib, PhD, Research Scientist
    • Hannah Perez, PsyD, Clinical Psychologist
    • Aime Ozuna, MPH, Research Coordinator
  • University of Southern California/Children's Hospital Los Angeles
    • Alexander Judkins, MD, Faculty Co-Investigator
    • Jenny Kingsley, MD, MA, Faculty Co-Investigator
    • Marian Williams, PhD, Faculty Co-Investigator
    • Suzanne Roberts, MD, Joint appointment to AltaMed Health Services Pediatric Care Center, Faculty Co-Investigator
  • AltaMed Health Services
    • Gabriela Tovar, JD, Institute for Health Equity
  • University of Southern California
    • Lauren Klein, Viterbi School of Engineering
  • Fiesta Educativa, Inc.
    • Irene Martinez, MSW, Executive Director
  • Para Los Niños
    • Natalia Garcia, Director of Community Resilience
  • St Anne's
    • Lorna Little, MSW, Chief Executive Officer
  • Karsh Family Social Service Center
    • Frances Nova, MSW, Director of Programs and Operations

Loma Linda University

"A Multi-Component Intervention to Strengthen Families and Build Youth Resilience."

Summary

This project will mobilize pediatricians, community health workers, and parenting educators to improve the delivery of information and resources to a diverse population of families with ACEs across the Inland Empire region. Service providers will be trained using an evidence-informed curriculum intended to strengthen families and build youth resilience. Biomarkers of toxic stress will be collected alongside ACE scores. At different timepoints, follow-up evaluations with children and families will indicate which intervention is most effective in decreasing toxic stress associated with ACEs, improving health outcomes, and reducing health disparities.

Project Team

Lead Principal Investigator
  • Ariane Marie-Mitchell, MD, PhD, MPH, Associate Professor of Preventive Medicine & Pediatrics, Loma Linda University
Principal Investigators
  • Marti Baum, MD, Medical Director-Community Engagement, Social Action Community (SAC) Health System; Physician Champion, Help Me Grow Inland Empire
  • Elizabeth Park, PsyD, Clinical Psychologist, SAC Health System
Key Partners, Collaborators, and Supporters
  • Loma Linda University
    • Nicholas J. Rockwood, PhD, Assistant Professor of Interdisciplinary Studies, School of Behavioral Health
    • Cameron L. Neece, PhD, Associate Professor, Dept. of Psychology
    • Maud Joachim-Célestin, MD, DrPH, MPH, Assistant Professor, School of Behavioral Health
  • University of California, Los Angeles
    • Steve W. Cole, PhD, Professor of Psychiatry & Biobehavioral Sciences and Medicine, Cousins Center for Psychoneuroimmunology, Semel Institute for Neurosciences & Human Behavior
    • Judith Carroll, PhD, Associate Professor of Psychiatry & Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Semel Institute for Neurosciences & Human Behavior
    • Teresa Seeman, PhD, Professor of Medicine & Epidemiology, David Geffen School of Medicine
  • Social Action Community Health System
    • Jason Lohr, MD, FAAFP, FACHE, Chief Executive Officer
  • Help Me Grow - Inland Empire
    • Ronald Stewart, PhD, Manager
  • El Sol Neighborhood Educational Center
    • Alex Fajardo, MCP, CFC, Executive Director, Co-Investigator
  • Walden Family Services
    • Sue Evans, Chief Operating Officer, Co-Investigator
  • First 5 San Bernardino
    • Karen E. Scott, Executive Director
  • Inland Empire Health Plan
    • Jarrod McNaughton, MBA, FACHE, Chief Executive Officer
  • San Bernardino County Children's Network
    • Janki Patel, MPH, Children's Network Officer
  • San Bernardino County Preschool Services
    • Phalos Haire, Director
  • San Bernardino County Unified School District
    • Harold J. Vollkommer, EdD, Interim Superintendent
  • Inland Empire Community Collaborative
    • Susan Gomez, MA, CRC, Chief Executive Officer

University of California, Irvine

"Using Precision Medicine to Tackle Impacts of Adverse and Unpredictable Experiences on Children's Neurodevelopment."

Summary

The burden of ACEs is not equally distributed, with greater risk of exposure among low socioeconomic and racial/ethnic minority communities. This project seeks to answer two unmet needs: 1. identify the degree that ACEs influence children’s neurodevelopment and 2. discover for each child a marker that can predict their level of resilience, so that targeted interventions can be delivered to children who need them most. The team aims to screen 100,000 children across Orange County and apply interdisciplinary expertise in brain development, emotional health, health disparities, community engagement, epigenetics, big data, and data-base design and sharing.

Project Team

Lead Principal Investigator
  • Tallie Z. Baram, MD, PhD, Bren Distinguished Professor, Director of the Conte Center, University of California, Irvine (UCI)
Principal Investigators
  • Michael Weiss, DO, FAAP, Vice President of Population Health, Children’s Hospital Orange County (CHOC)
  • Dan Cooper, MD, Associate Vice Chancellor for Clinical and Translational Science, Professor of Pediatrics and Biomedical Engineering, Director of the Institute for Clinical and Translational Research, UCI
  • Laura Glynn, PhD, Professor of Psychology, Associate Dean for Research, Chapman University
  • Candice Taylor Lucas, MD, Associate Professor, Co-Director of LEAD-ABC, UCI/CHOC
Key Partners, Collaborators, and Supporters
  • University of California, Irvine
    • David Keator, PhD, Research Professor, Database Structure Expert and Computational Scientist
    • Ali Mortazavi, PhD, Professor, ENCODE Human Genome Project Leader
    • Hal Stern, PhD, Professor of Statistics, Information and Computer Sciences; Interim Provost
    • Leslie Thompson, PhD, Co-Director of Precision Health Through Artificial Intelligence
    • Pramod Khargonekar, Vice Chancellor for Research
  • Children's Hospital Orange County
    • Louis Ehwerhemuepha, PhD, Senior Data Scientist
    • Mary L. Zupanc, MD, Co-Medical Director, Neuroscience Institute
  • Children's Hospital Orange County Primary Care Network
    • Charles Golden, DO, FAAP, Executive Medical Director
  • Chapman University
    • Thomas Piechota, PhD, PE, Vice President for Research
    • Sabrina Liu, PhD, Postdoctoral Researcher
  • Syntropy Technologies, LLC
    • James Kugler, Director
  • Illumina, Inc.
    • Mark Van Oene, Sr. Vice President and Chief Commercial Officer
  • The Simms/Mann Family Foundation
    • Victoria Mann Simms, PhD, President

University of California, San Francisco

"The Collaborative Approach to Examining Adversity and Building Resilience (CARE) Program."

Summary

The cross-disciplinary team will study how to enhance resilience in children and families who have experienced adversity. Though it is well understood that ACEs can impact life-long health, more knowledge is required, from both scientists and communities, to personalize and implement interventions to fit individual physiology and environmental circumstances. This project draws upon clinical intervention, stress-biology science, and community partnership to help us understand which children are most vulnerable to the effects of ACEs, what family and community-level factors provide the most buffering protection, and which interventions most improve child and family outcomes—and for whom.

Project Team

Lead Principal Investigator
  • Neeta Thakur, MD, MPH, Assistant Professor of Medicine, University of California, San Francisco (UCSF)
Principal Investigators
  • Lisa James, MA, Director of Health, Futures Without Violence
  • Dayna Long, MD, Co-Director, Center for Child and Community Health, UCSF Benioff Children's Hospital Oakland
  • Nicole R. Bush, PhD, Associate Professor of Psychiatry & Pediatrics, UCSF
  • Danielle Hessler, PhD, Associate Professor and Vice Chair of Research, Department of Family and Community Medicine, UCSF
  • Maryam Kia Keating, PhD, Professor and Licensed Clinical Psychologist, University of California, Santa Barbara
Key Partners, Collaborators, and Supporters
  • University of California, San Francisco
    • Danielle Sy Roubinov, PhD, Assistant Professor and Licensed Clinical Psychologist, Department of Psychiatry and Behavioral Sciences
    • Rosemarie de la Rosa, PhD, UC President's Postdoctoral Scholar
    • Mohsen Malekinejad, MD, MPH, DrPH, Assistant Professor, Department of Epidemiology and Biostatistics Institute for Global Health Sciences
    • Raphael Hirsch, MD, Department of Pediatrics
    • Neil R. Powe, MD, MPH, MBA, Vice-Chair of Medicine, UCSF; Chief of Medicine, Zuckerberg San Francisco General Hospital Constance B. Wofsy Distinguished Professor
    • W. Thomas Boyce, MD, Distinguished Professor of Pediatrics and Psychiatry, Emeritus
    • Alicia F. Lieberman, PhD, Irving Harris Endowed Chair in Infant Mental Health; Professor and Vice Chair for Faculty Development (joint affiliation with Zuckerberg San Francisco General Hospital as Director of the Child Trauma Research Program)
  • LifeLong Medical William Jenkins Health Center
    • Omoniyi Omotoso, MD MPH, FAAP, Associate Medical Director of Pediatrics
    • Michael Stacey, MD, MPH, Chief Medical Officer
  • Benioff Children's Hospital Oakland
    • Joan Jeung, MD, MPH, MS, Pediatrician (Joint affiliation with UCSF)
    • Mindy Benson PNP, FQHC Manager of Program and Projects
  • University of California, Santa Barbara
    • Miya Barnett, PhD, Assistant Professor, Licensed Clinical Psychologist, Department of Counseling, Clinical, & School Psychology
  • Santa Barbara Neighborhood Clinics
    • Andria Ruth, MD, Pediatrician
  • Harvard University
    • Jack P. Shonkoff, MD, Director, Center on the Developing Child; Professor of Pediatrics, Harvard Medical School and Boston Children's Hospital; and Research Staff, Massachusetts General Hospital
  • University of Delaware
    • Mary Dozier, PhD, Francis Alison Professor; Amy E. du Pont Chair of Child Development; and Professor, Psychological and Brain Sciences

Selection Process

Demonstration Projects were selected through a three-step competitive peer-review process by an independent, out-of-state Expert Selection Committee. Following the submission of Letters of Intent, expert reviewers employed a process for selection of Concept Proposals and Full Proposals (Finalist Stage) based on National Institutes of Health standards. Proposals were reviewed across several factors embedded in CIAPM's enabling statute, including the 1. potential for tangible benefit to patients within five years; 2. expertise of the team; 3. clinical and commercial potential; 4. potential to reduce health disparities; and 5. potential to scale and leverage multiple electronic health records systems, among other criteria listed in the RFP. Each proposal was also assigned an overall impact score. As per statutory requirements and the Request for Proposals, at least one project must be located in both northern and southern regions of California. Additionally, lead institutions may only receive one award.

Finalists

  • A Tale of Two Treatments: Approaches to Preventing Long-Term Negative Health Sequelae Among Low-Income Latinx Youth with ACEs, UCI
  • Adverse Childhood Experiences (ACEs) Mechanisms in Disease - The Role of DNA Methylation, UCLA
  • Getting to Healthy Outcomes of Pregnancy for Everyone: Addressing Risk for and Resiliency Against Adverse Pregnancy Outcomes in Women with Multiple Adverse Childhood Experiences and Their Infants (the HOPE-ACEs Study), UCSF
  • Identifying Social, Molecular, and Immunological Processes for Mitigating Toxic Stress and Enhancing Personalized Resilience, UCLA
  • Integration of Biomarkers to Inform Tailored Disease Management and Behavioral Interventions for Homeless Youth Experiencing Toxic Stress, UCLA
  • San Diego County, UCSD, & Community Partners Better Address ACEs with Precision Medicine & Organizational Change, UCSD
  • Shared DataEcosytem: A New Paradigm to Build Community Resilience and Inform Resource Allocation, Stanford University
  • Systems-Based, Multidisciplinary Assessment of Adversity and Toxic Stress for Individualized Care (The SYSTEMAATIC Project), Stanford University

Additional Applicants

  • A Life Course Health Development Approach to Measuring and Addressing the Health Impacts of Adverse Childhood Experiences, UCLA
  • A Precision Medicine Approach to ACEs Screening, Referral, and Treatment Effectiveness, Kaiser Permanente Southern California
  • A Precision Population Health Approach to Measuring and Reducing Exposure to ACEs in Inland Southern California, UC Riverside
  • ACEs and Specific Learning Disabilities: Patterns of Neurocognitive, Social, and Educational Features, UCSF
  • ACEs in Youth with Serious Mental Illness: The Need for Precision Medicine, UC Davis
  • And Still I RISE: Resilience In Students Experiencing ACEs, UC Davis
  • Biopsychosocial Predictors of Resilience and Treatment Effects in Youth Exposed to Adverse Childhood Experiences, UCI
  • Collaborative Community ACES Intervention to Reduce Health Disparities and Close the Academic Acheivement Gap, Touro University California
  • Developing Biomarker-Informed Primary Care Screening Tools for Mental and Physical Health Risk in Adversity Exposed youth, UCLA
  • Engineering an Integrated Systems Approach to Reduce ACEs and Promote Resilience in a Diverse Child, Adolescent, and Early Adult Population, Claremont Graduate University
  • Examining the Influence of Adverse Childhood Experiences and Childhood Stress on Brain Health Biomarkers in a Diverse Cohort of Older Adults Living in San Francisco, UCSF
  • Implementation and Evaluation of an ACE Screening and Treatment System, UC Merced
  • Interrupting Intergenerational Trauma: Trauma-Informed Approach to Public Health Nursing, UCSF
  • Mitigating Toxic Stress by Building Resilience in California's Latino Immigrant Communities: A Community-Engaged, Precision Medicine Approach, UC Davis
  • Nutritional Supplementation as a Means to Reduce Early Life Adversity In the Context of Substance Use in Pregnancy, UCSF
  • Precision Mental Health for Youth with Adverse Childhood Experiences From Low-Socioeconomic Status Families, UCSF
  • Ravenswood Wellness Partnership: Increasing Capacity and Access to Culturally Relevant and Responsive Mental Health and Wellness Services for Youth in East Palo Alto and Belle Haven, Stanford University
  • The Santa Barbara ACEs Project for Inclusion, Education and Diversity, Santa Barbara Cottage Hospital