Physiological Impacts of a Social Belonging Intervention: Implications for Individuals with Psychosocial Vulnerability Factors

Early life exposures to psychosocial risk factors like socioeconomic disadvantage, systemic racism, and childhood trauma are highly prevalent, and are linked with increased cardiometabolic risk over the life-course. Despite this, many individuals exposed to psychosocial risk remain healthy into adulthood. Social belonging, defined as a subjective sense of having positive relationships with others in a community, is one factor that may promote health “resilience.” Evidence shows remarkably robust effects of brief social belonging interventions in young adults on sustained academic and wellbeing improvements up to 11 years later, however, whether the effects of these types of interventions may extend to cardiometabolic health is unknown. The current study investigated the health-promotive effects of such a social belonging intervention on two cohorts of University of Pittsburgh students, randomized to either the intervention or a control activity in Spring 2022 (N = 598) and Fall 2023 (N = 453). Additionally, the study examined whether exposure to early life psychosocial vulnerability factors moderated the health-promotive effects of the intervention. In Winter 2023-2024, 305 participants completed a follow-up survey on general health, sleep, physical activity, and alcohol use. In Spring 2024, 52 participants underwent lab assessments for mean arterial pressure, inflammation, and waist circumference. Multilevel models showed that the social belonging intervention group had healthier sleep patterns at follow-up (γ= -0.75, 95% CI [-1.42, -0.07], p = .031), and that the intervention group, when compared with controls, was associated with reduced racial/ethnic differences in binge drinking (OR = 0.10, 95% CI [0.01, 0.97], p = .047). Specifically, Black, Native, and Latinx individuals in the intervention group were less likely to engage in binge drinking than Black, Native, and Latinx individuals in the control group. Surprisingly, the intervention was associated with greater waist circumference at follow-up (γ= 6.73, 95% CI [1.53, 11.9], p = .023), although this effect seemed to be driven by one influential case. No associations were found between the intervention and mean arterial pressure or inflammation. Moderation analyses did not find evidence that the intervention promoted physiological resilience in those exposed to childhood trauma and socioeconomic disadvantage. These results suggest that social belonging interventions in young adulthood may improve sleep and reduce excessive alcohol use 6 months to 2 years later. However, these behavioral changes did not translate to differences in cardiometabolic risk, possibly due to insufficient power, the relatively brief follow-up period, and the general health status of the sample. This study provides novel insights into the behavioral impacts of a social belonging intervention and its potential to promote resilience among at-risk young adults