Integrating Family Resilience and Cultural Assets to Inform the LEADS Health Promotion Trial with African American Families

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PROJECT SUMMARY/ABSTRACT African American adolescents have higher rates of overweight and obesity, as well as greater physical inactivity and poor dietary intake, compared to their White peers. Thus, African American adolescents are at greater risk for long-term health consequences, including chronic disease and early mortality. However, few health promotion programs and weight loss interventions have been successful among African American adolescents. Given the elevated rates of chronic stress (poverty, family conflict, racial discrimination) among African American adolescents, this may be a prominent obstacle for engagement and effectiveness of health promotion initiatives. Limited health promotion programs with African American families have incorporated a family-based resilience framework to address stress, and even fewer have utilized a cultural assets approach. Family resilience (family routines, social support, connectedness), as well as cultural assets (racial identity, proactive coping strategies, spirituality), which are primarily cultivated by parents, have been effective for improving mental health and academic performance but have not been implemented in health promotion programs. Preliminary work by the fellowship candidate, Sponsor, and Co-Sponsors showed that an online family-based cultural resilience health promotion pilot study integrating core content on family routines, proactive coping strategies, racial identity, and racial discrimination demonstrated high feasibility and acceptability among overweight African American adolescents and their families. To further expand this study, the Sponsor (Wilson) submitted the ‘Linking Exercise for Advancing Daily Stress Management’ (LEADS) R01 efficacy trial that will be reviewed in Fall 2021. The proposed study will extend this work to 1) develop core intervention curriculum components that build family resilience and cultural assets for the LEADS efficacy R01 trial focused on racial identity, developing coping skills for racism, and fostering cultural pride and spirituality and 2) test and evaluate the core intervention curriculum components developed in Aim 1 with African American families with a 3-week online pilot exposure study, with a specific focus on developing advanced program and process evaluation methods to capture parent socialization practices that promote resilience and health promotion (e.g., recorded sessions, surveys, qualitative follow-up interviews). Program and process evaluation data will allow further dissemination of comprehensive recommendations for future programs. This research will be conducted at the University of South Carolina, a Carnegie Mellon #1 research institution, with the support of a mentorship team with varying expertise. The proposed training plan will focus on 1) developing a comprehensive theoretical understanding of risk and resilience development in the context of health promotion programs and expand skills in culturally relevant research for minority youth, 2) demonstrating mastery of advanced qualitative and quantitative data analysis, 3) obtaining training and experience in process evaluation, and 4) further developing skills in scientific writing and grant writing, as well as developing skills in presenting research.