This study is structured around three main aims.

In Aim 1, investigators will conduct community-based participatory research (CBPR) to develop culturally tailored methods to assess childhood adversity in multiple sclerosis (MS).

Aim 2 will investigate the impact of childhood adversity on MS outcomes among individuals with relapsing-remitting MS (RRMS), among whom 70% belong to a group historically under-represented in MS research: Black, Hispanic, or poverty-impacted. Aim 2 procedures involve two visits that include a research blood draw and an MRI scan.

In Aim 3, investigators will conduct interviews and surveys to explore environmental and social factors affecting quality of life for minority MS patients.

Inclusion Criteria:

Aim 1 -

• aged ≥18-29 years
• diagnosis of RRMS (Fulfill international criteria for relapsing remitting (RRMS))
• 70% self-identifying as a Black, Hispanic, or poverty-impacted (up to 138% of the federal poverty level) individual,and
• fluent in English or Spanish.

Aim 2 -

• aged ≥18-29 years
• diagnosis of RRMS (Fulfill international criteria for relapsing remitting (RRMS))
• 70% self-identifying as a Black, Hispanic, or poverty impacted, and
• fluent reading in English or Spanish
• Pediatric onset MS (MS onset before age 18 and age at time of enrollment is 18-25) OR adult-onset MS (MS onset at age 18 or older and age at time of enrollment is 19-29)
• Disease duration below 8 years

Aim 3 -

Aim 3 will enroll the first 20 participants from Aim 2 who meet the following criteria:

• completed at least 80% of study data in the cross-sectional study/Aim 2.
• a total of 70% must self-identify as Black, Hispanic, or meet criteria for poverty impacted.
• interviews will be evenly split between participants with high (top quartile) and low (bottom quartile) of PROMIS-10 scores.

Exclusion Criteria:

• Primary or Secondary Progressive MS
• Inability to consent.
• MS relapse within 30 days prior to study entry
• Other major neurologic or psychiatric illness

• Aim 1: 2-3 focus groups, each with 8-12 participants per group., aged ≥18 years with RRMS, who self-identify as a Black, Hispanic, or poverty-impacted, and are fluent in English or Spanish.
• Aim 2: 330 young adults (ages 18-29 years of age with MS duration of 8 years or less) of whom 165 have pediatric-onset RRMS (aged 18-25) and 165 have adult-onset (aged 19-29) RRMS. 70% self-identify as persons with MS who are either Black, Hispanic, or poverty-impacted.
• Aim 3: 20 participants who have completed at least 80% of study data in the cross-sectional study/Aim 2. 70% must self-identify as Black, Hispanic, or meet criteria for poverty impacted.

The de-identified participant data from the final research dataset will be shared upon reasonable request beginning 9 to 36 months after publication or as required by a condition of awards or supporting agreements, provided the requesting investigator executes a data use agreement with NYU Langone Health. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's Data Sharing Strategy Board (DSSB). Requests should be directed to: kimberly.oneill@nyulangone.org. The protocol and statistical analysis plan will be posted on Clinicaltrials.gov only as required by federal regulation or supporting awards and agreements.

Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.

The investigator who proposed to use the data will be granted access upon reasonable request. Requests should be directed to kimberly.oneill@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.