California Stress, Trauma, and Resilience Study (CalSTARS) protocol: A multiomics-based cross-sectional investigation and randomized controlled trial to elucidate the biology of ACEs and test a precision intervention for reducing stress and enhancing resilience
Lauren Y. Kim,
Sophia Miryam Schüssler-Fiorenza Rose,
Summer Mengelkoch,
Daniel P. Moriarity,
Jeffrey Gassen,
Jenna C. Alley,
Lydia G. Roos,
Tao Jiang,
Arash Alavi,
Durga Devi Thota,
Xinyue Zhang,
Dalia Perelman,
Tamar Kodish,
Janice L. Krupnick,
Michelle May,
Katy Bowman,
Jenna Hua,
Yaping Joyce Liao,
Alicia F. Lieberman,
Atul J. Butte,
Patricia Lester,
Shannon M. Thyne,
Joan F. Hilton,
Michael P. Snyder,
George M. Slavich
Affiliations
Lauren Y. Kim
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Sophia Miryam Schüssler-Fiorenza Rose
Department of Genetics, Stanford University, Stanford, CA, USA
Summer Mengelkoch
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Daniel P. Moriarity
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Jeffrey Gassen
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Jenna C. Alley
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Lydia G. Roos
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Tao Jiang
Institute for Policy Research, Northwestern University, Evanston, IL, USA
Arash Alavi
Department of Genetics, Stanford University, Stanford, CA, USA
Durga Devi Thota
Department of Genetics, Stanford University, Stanford, CA, USA
Xinyue Zhang
Department of Genetics, Stanford University, Stanford, CA, USA
Dalia Perelman
Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
Tamar Kodish
Department of Psychology, University of California, Los Angeles, CA, USA
Janice L. Krupnick
Department of Psychiatry, Georgetown University, Washington, DC, USA
Michelle May
Am I Hungry? Mindful Eating Programs and Training, Phoenix, AZ, USA
Katy Bowman
Nutritious Movement, Carlsborg, WA, USA
Jenna Hua
Million Marker Wellness, Inc, Berkeley, CA, USA
Yaping Joyce Liao
Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA
Alicia F. Lieberman
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
Atul J. Butte
Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
Patricia Lester
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Shannon M. Thyne
Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Joan F. Hilton
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
Michael P. Snyder
Department of Genetics, Stanford University, Stanford, CA, USA
George M. Slavich
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
Adverse Childhood Experiences (ACEs) are very common and presently implicated in 9 out of 10 leading causes of death in the United States. Despite this fact, our mechanistic understanding of how ACEs impact health is limited. Moreover, interventions for reducing stress presently use a one-size-fits-all approach that involves no treatment tailoring or precision. To address these issues, we developed a combined cross-sectional study and randomized controlled trial, called the California Stress, Trauma, and Resilience Study (CalSTARS), to (a) characterize how ACEs influence multisystem biological functioning in adults with all levels of ACE burden and current perceived stress, using multiomics and other complementary approaches, and (b) test the efficacy of our new California Precision Intervention for Stress and Resilience (PRECISE) in adults with elevated perceived stress levels who have experienced the full range of ACEs. The primary trial outcome is perceived stress, and the secondary outcomes span a variety of psychological, emotional, biological, and behavioral variables, as assessed using self-report measures, wearable technologies, and extensive biospecimens (i.e. DNA, saliva, blood, urine, & stool) that will be subjected to genomic, transcriptomic, proteomic, metabolomic, lipidomic, immunomic, and metagenomic/microbiome analysis. In this protocol paper, we describe the scientific gaps motivating this study as well as the sample, study design, procedures, measures, and planned analyses. Ultimately, our goal is to leverage the power of cutting-edge tools from psychology, multiomics, precision medicine, and translational bioinformatics to identify social, molecular, and immunological processes that can be targeted to reduce stress-related disease risk and enhance biopsychosocial resilience in individuals and communities worldwide.
