Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention




Eileen M. Condon, Amalia Londono Tobon, Brianna Jackson, Margaret L. Holland, Arietta Slade, Linda Mayes, and Lois S. Sadler.

Brief Type

Journal Publication


  • Minding the Baby


Background: Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism. Objective: The purpose of this study is to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress, and to test whether relationships are moderated by prior participation in Minding the Baby® (MTB), an attachment-based early home visiting intervention. Methods: Ninety-seven maternal-child dyads (n=43 intervention dyads, n=54 control dyads) enrolled in the MTB Early School-Age follow up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., c-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress, and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention. Results: Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary IL-6 and TNF-α levels in children, but not child BMI or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child IL-6 levels. Discussion: Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic level intervention. (author abstract)

Data Collection Methods

  • Standardized assessment tools



For More Information

Condon, E. M., Londono Tobon, A., Jackson, B., Holland, M. L., Slade, A., Mayes, L., & Sadler, L. S. (2021). Maternal experiences of racial discrimination, child indicators of toxic stress, and the Minding the Baby early home visiting intervention. Nursing Research, 70(5), S43–S52. https://doi.org/10.1097/NNR.0000000000000529

Author Contact Information:

Eileen M. Condon, PhD, APRN, FNP-BC



  • Participant Characteristics
  • Participant, Family, and Program Outcomes