Family-Centered Prevention Effects on the Association Between Racial Discrimination and Mental Health in Black Adolescents: Secondary Analysis of 2 Randomized Clinical Trials.
Family-Centered Prevention Effects on the Association Between Racial Discrimination and Mental Health in Black Adolescents: Secondary Analysis of 2 Randomized Clinical Trials.
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以家庭为中心的预防对黑人青少年种族歧视与心理健康之间关系的影响：2项随机临床试验的次要分析。
DOI：
10.1001/jamanetworkopen.2021.1964
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发表时间：
2021-03-01
影响因子：
13.8
通讯作者：
Kogan SM
中科院分区：
文献类型：
--
作者：
Brody GH;Yu T;Chen E;Miller GE;Barton AW;Kogan SM
参加以家庭为中心的预防计划，旨在加强照料实践，是否与保护黑人青少年免受种族歧视对其心理健康的影响有关？对2个随机临床试验的数据进行的二次分析发现，参与以家庭为中心的预防计划与保护黑人青少年免受种族歧视对行为问题(两个试验)和抑郁/焦虑症状(1个试验)的影响有关。这些关联部分是由干预导致的保护性父母养育方式的变化解释的。这些发现表明，以家庭为中心的预防计划减少了种族歧视对黑人青少年心理健康问题随后增加的影响。这项对2个随机临床试验的二次分析检验了以家庭为中心的预防计划在调解黑人青年中与种族歧视经历相关的不利心理健康结果方面的效果。一些经常遭受种族歧视的黑人青少年会出现心理健康问题。保护性照料可以缓解青少年因遭受种族歧视而产生的消极心理健康后果。研究参加加强保护性照料的计划是否会减弱黑人青少年遭遇歧视与随后心理健康问题增加之间的正向关联。这项二次分析使用了2项随机临床试验的数据，这些试验测试的是以家庭为中心的预防计划：强大的非裔美国人家庭-青少年计划(SAAF-T)和成人成长中计划(AIM)。这些方案是在佐治亚州12个农村县方便参与者的社区地点实施的。在SAAF-T试验中，黑人青少年和他们的主要照顾者从2007年到2008年被招募。在AIM试验中，2006年至2007年招募了黑人青少年及其主要照顾者。这项研究的数据分析了2020年6月至8月。青少年提供了关于他们遭遇种族歧视的频率的基线数据。每项试验的治疗组参与者都参加了以家庭为中心的预防计划，旨在防止药物使用和精神健康问题。SAAF-T是一项为期5个疗程、10个小时的心理社会干预，针对14至16岁黑人青少年的家庭。AIM是一项为期6个疗程、12小时的心理社会干预，针对有黑人青年高三学生的家庭。主要结果是精神健康问题，包括行为问题和抑郁或焦虑症状。SAAF-T研究包括502名黑人青少年(平均年龄16.0[0.6]岁；281名女孩[56.0%])，包括252名随机进入干预组和250名随机进入对照组；AIM试验包括367名黑人青少年(平均年龄17.7[0.8]岁；217名[59.1%]女孩和妇女)，包括187名随机进入干预组和180名随机进入对照组。被分配到SAAFT干预组的青少年在基线上经常经历歧视，表现出随后行为问题增加的较少(事件风险比，0.530[95%CI，0.340至0.783])。被分配到AIM干预组的青少年如果在基线上经常经历歧视，那么随后行为问题的增加(平均差异，−0.361[95%CI，−0.577至−0.144])和随后抑郁或焦虑症状的增加(Mean Difference，−0.220[95%CI−0.402至−0.038])较少。经调节的调解分析表明，加强保护性照料是所有观察到的交互作用效应的部分原因(间接影响：SAAF-T行为问题，−0.063[95%CI，−0.127至−0.001]；AIM行为问题，−0.048[95%CI，−0.095至−0.001]；AIM抑郁或焦虑症状，−0.036[95%CI，−0.074至0])。这项对2个随机临床试验的二次分析发现，参与以家庭为中心的预防干预措施可以减弱频繁暴露于歧视行为和随后的精神健康问题之间的联系。值得注意的是，除了1项外，所有的治疗和缓和调解的结果都在SAAF-T和AIM试验中重现。ClinicalTrials.gov标识：SAAF-T，NCT04501471；AIM，NCT04510116
Is participation in a family-centered prevention program, designed to enhance caregiving practices, associated with protection of Black adolescents from the effects of racial discrimination on their mental health? This secondary analyses of data from 2 randomized clinical trials found that participation in a family-centered prevention program was associated with protection of Black adolescents from the effects of racial discrimination on conduct problems (in both trials) and on depression/anxiety symptoms (in 1 trial). These associations were partially explained by intervention-induced changes in protective parenting. These findings suggest that family-centered prevention programs reduce the effects of racial discrimination on subsequent increases in mental health problems among Black adolescents. This secondary analysis of 2 randomized clinical trials examines the effects of family-centered prevention programs in mediating the adverse mental health outcomes associated with experience of racial discrimination among Black youths. Some Black adolescents who frequently experience racial discrimination develop mental health problems. Protective caregiving may buffer adolescents from the negative mental health outcomes associated with experiencing racial discrimination. To examine if participation in programs that enhance protective caregiving will attenuate the positive association between Black adolescents’ encounters with discrimination and subsequent increases in mental health problems. This secondary analysis used data from 2 randomized clinical trials testing family-centered prevention programs: the Strong African American Families–Teen (SAAF–T) program and the Adults in the Making (AIM) program. The programs were implemented in community locations convenient for participants in 12 rural Georgia counties. For the SAAF–T trial, Black adolescents and their primary caregivers were recruited from 2007 to 2008. In the AIM trial Black adolescents and their primary caregivers were recruited from 2006 to 2007. Data for this study were analyzed from June to August 2020. Adolescents provided data at baseline on the frequency of their encounters with racial discrimination. Treatment group participants in each trial took part in a family-centered prevention program designed to prevent substance use and mental health problems. SAAF–T is a 5-session, 10-hour psychosocial intervention for families with a Black adolescent aged 14 to 16 years. AIM is a 6-session, 12-hour psychosocial intervention for families with a Black youth who is a high school senior. The primary outcomes were mental health problems, including conduct problems and depression or anxiety symptoms. The SAAF–T study included 502 Black adolescents (mean [SD] age, 16.0 [0.6] years; 281 [56.0%] girls), including 252 randomized to the intervention and 250 randomized to the control, and the AIM trial included 367 Black adolescents (mean [SD] age, 17.7 [0.8] years; 217 [59.1%] girls and women), including 187 randomized to the intervention and 180 randomized to the control. Adolescents assigned to the SAAF–T intervention group who frequently experienced discrimination at baseline evinced fewer subsequent increases in conduct problems (incident risk ratio, 0.530 [95% CI, 0.340 to 0.783]). Adolescents assigned to the AIM intervention group who frequently experienced discrimination at baseline evinced fewer subsequent increases in conduct problems (mean difference, −0.361 [95% CI, −0.577 to −0.144]) and fewer subsequent increases in depression or anxiety symptoms (mean difference, −0.220 [95% CI −0.402 to −0.038]). Moderated mediation analyses suggested that enhanced protective caregiving was partially responsible for all observed interaction effects (indirect effect: SAAF-T conduct problems, −0.063 [95% CI, −0.127 to −0.001]; AIM conduct problems, −0.048 [95% CI, −0.095 to −0.001]; AIM depression or anxious symptoms, −0.036 [95% CI, −0.074 to 0]). This secondary analysis of 2 randomized clinical trials found that participation in family-centered preventive interventions attenuated the association between frequent exposure to discriminatory behaviors and subsequent mental health problems. Notably, all but 1 of the treatment and moderated-mediation findings were reproduced across the SAAF–T and AIM trials. ClinicalTrials.gov Identifiers: SAAF–T, NCT04501471; AIM, NCT04510116
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影响因子：
3.6
作者：
Sellers, RM;Copeland-Linder, N;Lewis, RL
通讯作者：
Lewis, RL
影响因子：
2.8
作者：
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作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
1.2
作者：
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通讯作者：
RADLOFF L S