Department of Human Development and Family Science, University of Georgia, Athens.
Department of Public Health, Baylor University, Waco, Texas.
JAMA Netw Open. 2023 Nov 1;6(11):e2340567. doi: 10.1001/jamanetworkopen.2023.40567.
Racial discrimination undermines the mental health of Black adolescents. Preventive interventions that can attenuate the effects of exposure to racial discrimination are needed.
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.
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.
The main outcome was adolescent-reported depressive symptoms, assessed at 34 months via the 20-item Center for Epidemiologic Studies Depression Scale for Children.
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).
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.
ClinicalTrials.gov Identifier: NCT03590132.
种族歧视会损害黑青少年的心理健康。需要预防干预措施来减轻接触种族歧视的影响。
研究参加坚强非裔美国家庭（SAAF）计划是否能减轻与种族歧视经历相关的黑青少年的抑郁症状。
设计、地点和参与者：这是一项对 SAAF（SAAF 与无治疗对照组）进行的基于社区的随机临床试验的二次分析。参与者在基线评估后 10、22 和 34 个月进行了随访。评估人员对参与者的情况一无所知。该试验的参与者居住在佐治亚州的 7 个农村县。SAAF 在当地社区中心提供。合格的家庭有一个 11 到 12 岁的孩子，孩子自认为是非裔美国人或黑人。研究了随机分配给 SAAF 和接触种族歧视的联合影响。数据于 2022 年 9 月至 2023 年 3 月进行分析。
SAAF 是一项 7 节（14 小时）的家庭技能培训干预措施，共 7 周。一组照顾者及其青少年参加了一个有组织的课程，重点是有效的育儿行为、青少年自我调节和黑人自豪感。
主要结果是青少年在 34 个月时报告的抑郁症状，通过儿童流行病学研究抑郁量表的 20 项评估。
从公立学校名单中随机筛选出 825 个家庭，其中 472 名青少年（平均[SD]年龄 11.6 岁；240[50.8%]为女性）被纳入并随机分配到 SAAF（252 名参与者）或无治疗对照组（220 名参与者）。13 岁时接触种族歧视与 14 岁时抑郁症状增加有关（β=0.23；95%CI，0.13 至 0.34；P<0.001）。交互分析表明，实验条件显著调节了种族歧视与抑郁症状之间的关联：（β=-0.27；95%CI，-0.47 至-0.08；P=0.005）。在 ±SD 处探测交互作用的简单斜率显示，对于对照组，种族歧视与抑郁症状显著相关（β=0.39；95%CI，0.23 至 0.54；P<0.001），而对于 SAAF 组，种族歧视与抑郁症状之间没有关联（β=0.12；P=0.09）。
这项随机临床试验发现，SAAF 干预措施降低了黑青少年与种族主义相关的心理健康症状的发生率。建议向与农村黑青少年合作的医疗保健从业者推广 SAAF。
ClinicalTrials.gov 标识符：NCT03590132。
