Psychosocial and Neural Mechanisms for a Culturally and Linguistically Adapted Treatment for Bilingual Latino Young Adults with Autism

/Abstract Candidate: This K99/R00 Pathway to Independence Award proposal aims to provide me with the training needed (K99 phase) to execute mental health clinical trials (R00 phase) for Latinos with autism spectrum disorder (ASD) during their transition to adulthood.1 My preliminary community-based participatory research work2 found that Latinos with ASD may benefit from culturally adapted programs to help build skills to manage mental health, executive functioning, and socialization.3 As my research progressed, I became interested in the neural biomarkers that illustrate mechanism of treatment response. These experiences helped shape the direction for this K99/R00 proposal, which aims to complete the necessary research and concurrent training (K99) to conduct a randomized controlled trial (RCT) of a culturally and linguistically adapted therapy program (¡Iniciando! la Adultez)4 for Latino young adults with ASD and their Spanish-speaking parents. This proposal will also allow me to learn how to identify neural mechanisms of action (R00). To accomplish the goals for this K99/R00 project, I will complete training in: 1) implementation science to improve mental health disparities for Latinos with ASD, 2) RCT design and execution, 3) advanced neuroimaging, and 4) professional development. Research: Young adults with ASD transitioning to adulthood (18-25 years old) in the United States experience the highest rates of co-occurring depression or anxiety when compared to the general population.5 The pandemic access yet for recent highlighted underlying systemic disparities facing Latino young adults with ASD, including limited to mental health care 6. Culturally adapted and translated i nterventions are significantly more effective, it is disappointing that l ittle evidence examines the promise of treating co-occurring mental health disorders Latinos. Latinos are also not represented in research that could help accelerate clinical interventions 7 8–11 (i.e., neural and psychosocial mechanisms of action).12 Neural and psychosocial mechanisms of action have the power to enhance treatment efficacy, optimize therapeutic personalization, and scientific validation.13,14 The dearth and of research evaluating ulturally adapted and translated interventions from a multimodal (e.g., neural psychosocial) perspective maintain long-term health inequities for Latinos with ASD. c 11,15,16To address the need to identify the neural and psychosocial mechanisms of action for culturally-adapted treatments for Latinos with ASD and their Spanish-speaking parents during the transition to adulthood, I will 1) finalize the culturally adapted and translated ¡Iniciando! program (Aim 1a) and neuroimaging protocol (Aim 1b), 2) conduct a RCT of the ¡Iniciando! through telemedicine technology by community health workers and therapists with Latino young adults with ASD and depression or anxiety and their Spanish-speaking parents (n = 100 dyads), and 3) identify potential neural and psychosocial mechanisms of action for a subset of young adults (n = 60) from the RCT. This K99/R00 research and training plan is in line with NICHD's priorities and cross-cutting topics to improve Latino adolescent physical and mental health functioning during the transition to adulthood. Project Number: 1K99HD118079-01 | Fiscal Year: 2025 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Antonio Pagán | Institution: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON, HOUSTON, TX | Award Amount: $132,033 | Activity Code: K99 | Study Section: Biobehavioral and Behavioral Sciences Study Section[CHHD-H] View on NIH RePORTER: https://reporter.nih.gov/project-details/1K99HD11807901