Family-Centered Prevention to Reduce Discrimination-Related Depressive Symptoms Among Black Adolescents: Secondary Analysis of a Randomized Clinical Trial.

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  • Additional Information
    • Source:
      Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
    • Publication Information:
      Original Publication: Chicago, IL : American Medical Association, [2018]-
    • Subject Terms:
      Black or African American* ; Depression*/ethnology ; Depression*/prevention & control ; Racism*/ethnology ; Racism*/psychology ; Mental Health*/ethnology ; Adolescent Health*/ethnology; Adolescent ; Child ; Female ; Humans ; Male ; Black People ; Control Groups ; Curriculum ; Family Health/ethnology ; Follow-Up Studies ; Rural Population ; Parenting/ethnology ; Parenting/psychology
    • Abstract:
      Importance: Racial discrimination undermines the mental health of Black adolescents. Preventive interventions that can attenuate the effects of exposure to racial discrimination are needed.
      Objective: To investigate whether participation in the Strong African American Families (SAAF) program moderates Black adolescents' depressive symptoms associated with experience of racial discrimination.
      Design, Setting, and Participants: This secondary analysis used data from a community-based randomized clinical trial of SAAF (SAAF vs no treatment control). Participants were followed up at 10, 22, and 34 months after the baseline assessment. Assessment staff were blind to participant condition. Participants in this trial lived in 7 rural counties in Georgia. SAAF was delivered at local community centers. Eligible families had a child aged 11 to 12 years who self-identified as African American or Black. The joint influence of random assignment to SAAF and exposure to racial discrimination was investigated. Data were analyzed from September 2022 to March 2023.
      Intervention: SAAF is a 7-session (14 hours) family skills training intervention that occurs over 7 weeks. Small groups of caregivers and their adolescents participate in a structured curriculum targeting effective parenting behavior, adolescent self-regulation, and Black pride.
      Main Outcomes and Measures: The main outcome was adolescent-reported depressive symptoms, assessed at 34 months via the 20-item Center for Epidemiologic Studies Depression Scale for Children.
      Results: Of 825 families screened randomly from public school lists, 472 adolescents (mean [SD] age, 11.6 years; 240 [50.8%] female) were enrolled and randomized to SAAF (252 participants) or a no treatment control (220 participants). Exposure to racial discrimination at age 13 years was associated with increased depressive symptoms at age 14 years (β = 0.23; 95% CI, 0.13 to 0.34; P < .001). Interaction analyses indicated that the experimental condition significantly moderated the association of racial discrimination with depressive symptoms: (β = -0.27; 95% CI, -0.47 to -0.08; P = .005). Probing the interaction with simple slopes at ±SD revealed that for the control group, racial discrimination was significantly associated with depressive symptoms (β = 0.39; 95% CI, 0.23 to 0.54; P < .001), while for the SAAF group, there was no association between racial discrimination and depressive symptoms (β = 0.12; P = .09).
      Conclusions and Relevance: This randomized clinical trial found that the SAAF intervention reduced the incidence of racism-associated mental health symptoms among Black adolescents. SAAF is recommended for dissemination to health care practitioners working with rural Black adolescents.
      Trial Registration: ClinicalTrials.gov Identifier: NCT03590132.
    • Comments:
      Comment in: JAMA Netw Open. 2023 Nov 1;6(11):e2340577. doi: 10.1001/jamanetworkopen.2023.40577. (PMID: 37910107)
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    • Grant Information:
      TL1 TR002382 United States TR NCATS NIH HHS; UL1 TR002378 United States TR NCATS NIH HHS
    • Molecular Sequence:
      ClinicalTrials.gov NCT03590132
    • Publication Date:
      Date Created: 20231101 Date Completed: 20231220 Latest Revision: 20240925
    • Publication Date:
      20250114
    • Accession Number:
      PMC10620615
    • Accession Number:
      10.1001/jamanetworkopen.2023.40567
    • Accession Number:
      37910105