Teaching Youth & Families Self-Regulation Skills to Disrupt the Impact of Adverse Childhood Experiences: The THRIVE Study Protocol for a Randomized Controlled Trial.

Background: Adverse Childhood experiences (ACEs) disproportionately affect minoritized and low-income youth. Those with four or more ACEs are particularly vulnerable to chronic, unpredictable stress, which shapes their stress perception and response. Higher exposure to ACEs is associated with an increased risk of self-dysregulation, early initiation of alcohol and substance use, and cardiometabolic issues, including disruptions in heart rate variability, sleep disturbances, weight dysregulation, and elevated blood pressure. While some evidence-based family interventions aimed at preventing traumatic stress exist, research explicitly focused on interventions using psychoeducation incorporating biofeedback remains limited. The purpose of this paper is to describe the study protocol for a randomized controlled trial with adversity-impacted adolescents ages 11 to 14 and their caregivers. The THRIVE Study examines the efficacy of the Garnering Resilience in Traumatized youth and families (GRIT) intervention, a psychoeducational coaching program focused on building buffering protective factors, compared to an attention control group receiving a grade-specific Digital Literacy Intervention in delaying the initiation of alcohol and cannabis use. Methods: Adolescent-caregiver dyads (n= 210) are recruited to participate in six 1-hour intervention sessions conducted over 8 weeks via Zoom, facilitated by an intervention-specific community health worker (CHW). In-person assessments are conducted at specific time points: pre-intervention, post-intervention, 6-month follow-up, and 12-month follow-up. During these assessments, heart rate variability using the emWave Pro Plus and survey data are collected using REDCap to evaluate emotional and cognitive function, and behavioral outcomes (e.g., sleep disturbances and substance use). Additionally, participants complete a booster session and online surveys at 6-months post intervention. Discussion: The THRIVE Study evaluates a psychoeducational health coaching intervention that incorporates biofeedback. The findings from this RCT have the potential to build buffering protective factors in adversity-impacted adolescents and their caregivers, reducing long-term health inequities among minoritized and underserved populations. Trial registration: trial registration name: ClinicalTrials.gov, trial registration number: NCT06821035, registration on date: July 18th, 2025.