# Understanding and Reversing the Effects of Early Life Adversity on Midlife Health: Improving Daily Psychological Stress Responses using an Ecological Momentary Intervention

> **NIH NIH R00** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $248,999

## Abstract

PROJECT SUMMARY/ABSTRACT
Early life adversity (ELA), such as childhood maltreatment, can leave a “scar” into adult life and beyond,
increasing risk for mental health problems and physical diseases of aging. ELA is also linked with biological
indices that are reliable precursors to early disease, such as elevated blood pressure and C-reactive protein,
and shortened telomere length–biomarkers I will study in this proposal. Identifying the persistent risk pathways
by which ELA worsens midlife health can inform interventions. While research on the biological mechanisms
has proliferated, our understanding of the psychological mechanisms, which can inform non-pharmacological
interventions, has lagged behind. Congruent with the National Institute on Aging’s initiative on the reversibility
of ELA, the proposed project aims to 1) understand daily psychological stress responses (e.g., negative affect,
stress appraisals, and perseverative cognitions) as a promising psychological risk pathway, and to 2) develop
and 3) pilot test an intervention that improves maladaptive psychological responses to daily stressors. The
proposed intervention will use daily mindfulness-based practices that are incorporated into everyday life via
mobile technology (Ecological Momentary Intervention). To this end, I will first identify intervention targets by
examining relations between ELA, daily psychological stress responses, and health outcomes (mental/physical
symptoms; biomarkers) in two existing midlife studies with prospective and retrospective assessments of ELA.
Next, I will develop an Ecological Momentary Mindfulness-based Intervention (EMMI) that improves
maladaptive daily psychological stress responses using a small micro-randomized trial (n=20). Lastly, I will
pilot test acceptability, feasibility, and adherence by randomizing participants with ELA to EMMI (n=35) or
Ecological Momentary Assessment-only (n=35). Preliminary findings will inform an R-level application to
evaluate the EMMI in an adequately powered study. This research will advance our knowledge of the midlife
reversibility of psychological risk pathways related to ELA. Building on my advanced training as a clinical and
health psychologist with expertise in stress, psychoneuroendocrinology, and mental health, the K99/R00
Pathway to Independence Award addresses critical training needs in ecological momentary assessment and
intervention, mechanism-focused intervention development and testing, mindfulness-based interventions, and
measurement and interpretation of aging biomarkers. The training plan includes coursework, meetings,
readings, and apprenticeships to fill these gaps; the research proposal provides opportunities to apply the new
knowledge. I have assembled an outstanding team of renowned mentors (Drs. Epel, Hecht, Almeida) and
specialized advisors (Drs. Danese, Murphy, Mendes, Delucchi) with expertise in these areas. The proposed
award will provide me with the necessary experiences to become an ind...

## Key facts

- **NIH application ID:** 10319262
- **Project number:** 4R00AG062778-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Stefanie Eva Mayer
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $248,999
- **Award type:** 4N
- **Project period:** 2019-04-15 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10319262

## Citation

> US National Institutes of Health, RePORTER application 10319262, Understanding and Reversing the Effects of Early Life Adversity on Midlife Health: Improving Daily Psychological Stress Responses using an Ecological Momentary Intervention (4R00AG062778-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10319262. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*