Infectious Disease

Family interventions can reduce the psychiatric effects of discrimination on black youth

March 24, 2021

3 min read

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Participation in family-oriented prevention programs has reduced the effects of racial discrimination on the subsequent increase in mental health problems among black youth. This emerges from the study results published in JAMA Network Open.

“The SAAF-T (Strong African American-Teen) program was developed for young people between the ages of 14 and 16 and the AIM (Adults in the Making) program for young people between the ages of 17 and 18.” Gene H. Brody, PhD, of the Center for Family Research at the University of Georgia, and colleagues wrote. “Both programs are designed to prevent mental health problems and substance use by improving protective care. Previous research with the SAAF-T and AIM studies focused on determining their effectiveness and durability in preventing substance use and mental health problems. Both interventions have also been shown to mitigate the effects of life stress on black adolescents through increased protective care, and both programs have demonstrated stress-buffering capacities for a range of psychosocial outcomes. “

However, previous studies have not assessed the impact of these interventions on addressing discrimination among adolescents. To fill this research gap, Brody and colleagues performed the current secondary analysis of two randomized clinical trials evaluating SAAF-T and AIM. Both were conducted at community locations accessible to individuals in 12 Georgia rural counties. The SAAF-T and AIM studies included black adolescents and their primary caregivers recruited for SAAF-T (n = 502 adolescents) between 2007 and 2008 and for AIM (n = 367) between 2006 and 2007. The basic data of the adolescents on the frequency of their encounters with racial discrimination served as exposure. SAAF-T comprised five sessions of 10-hour psychosocial interventions for families with a black adolescent, ages 14-16, and AIM comprised six sessions of 12-hour psychosocial interventions for families with a black high school senior. Mental health problems such as behavior problems and anxiety or symptoms of depression served as the main outcomes and actions.

The results showed fewer subsequent increases in behavior problems (incident risk ratio = 0.53; 95% CI, 0.34-0.783) in adolescents in the SAAF-T intervention, who were often discriminated against at the start of the study. In addition, the researchers observed fewer subsequent increases in behavior problems (mean difference = 0.361; 95% CI, 0.577 to 0.144) and anxiety or depression symptoms (mean difference = 0.22; 95% CI, 0.402 to 0.038) among those in the AIM Intervention that was often discriminated against at the start of the study. According to moderated mediation analyzes, all observed interaction effects seemed to be partly due to improved protective care.

“Clinically, the results suggest that SAAF-T, AIM, and possibly other interventions that focus on strengthening protective care could help prevent or mitigate some of the mental health problems that can arise from racial discrimination,” wrote Brody and colleagues. “Of particular importance for pediatric clinical practice are effective family-oriented prevention programs to improve protective care for black adolescents, adolescents and adolescents who are about to transition into young adulthood. Participation in these programs was associated with stress-buffering effects on self-control development and on reductions in drug use, obesity, cytokine levels, epigenetic aging and, in this study, post-discrimination mental health problems. “

In a related editorial Samantha V. Hill, MD, MPH, and Tamera Coyne-Beasley, MD, MPH, of the Department of Pediatrics at the University of Alabama in Birmingham outlined possible avenues for future interventions.

“During interventions like Brody’s investigated [and colleagues] are important, it can be ambitious to expect that short-term programs can fully improve the psychosocial and physical health outcomes of continuous exposure to racism, “wrote Hill and Coyne-Beasley. “Because ‘racism is a socially transmitted disease,’ as explained [in an American Academy of Pediatrics commentary]Future interventions must be deliberate, long-term, continuous, and geared towards primary prevention and reduction of racism, the main cause of mental inequalities that Brody investigates [and colleagues]. Above all, this intentionality must extend to all expressions of racism, including less recognized variations such as prejudice, stereotypes, microaggression, tokenism and color blindness. “

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Race and medicine

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