Making deep-structure adaptations: A community-engaged qualitative study for culturally adapting suicide prevention interventions for Black youth.

Implementation Science in Suicide Prevention.

Historically, racial socialization (RS) literature has focused on the content and frequency of RS messages communicated between Black parents and youth. In an effort to examine the potential added benefit of receiving RS messages from non-parental agents, three hierarchical linear regressions were tested among a sample of Black youth (ages 14–21). Black youths’ acquisition of protection and bicultural coping messages from parents were associated with their belief in racial protection messages along with select relevant covariates. Black youths’ acquisition of protection and racial stereotyping messages from parental agents and racial stereotyping messages from non-parental agents were associated with their belief in racial stereotyping messages. Finally, Black youths’ belief in bicultural coping messages were association with their acquisition of protection, racial stereotyping, and bicultural coping messages from parental agents and racial stereotyping and bicultural coping messages from non-parental agents. Findings underscore the enduring role parental and non-parental figures serve in Black youths’ racial socialization experiences across ecological contexts. As such, future interventions and community-based programs should be oriented towards equipping parents and supports for Black youth (e.g., including multiracial families) with the competency to communicate racial pride and skillfully support Black children’s management of racialized experiences.

A Systematic Review and Meta-Analysis: Psychotherapy Interventions for Reducing Suicidal Thoughts and Behaviors Among Black Youth

The frequent police killings during the COVID-19 pandemic forced a reckoning among Americans from all backgrounds and propelled the Black Lives Matter movement into a global force. This manuscript addresses major issues to aid practitioners in the effective treatment of African Americans via the lens of Critical Race Theory and the Bioecological Model. We place the impacts of racism on Black families in historical context and outline the sources of Black family resilience. We critique structural racism embedded in all aspects of psychology and allied fields. We provide an overview of racial socialization and related issues affecting the parenting decisions in Black families, as well as a detailed overview of impacts of structural racism on couple dynamics. Recommendations are made for engaging racial issues in therapy, providing emotional support and validation to couples and families experiencing discrimination and racial trauma, and using Black cultural strengths as therapeutic resources.

The aim of this study is to examine service utilization disparities among Black youth participating in Linking Individuals Needing Care (LINC), a 90-day research-informed suicide care coordination intervention. An open trial pilot was conducted to examine the effectiveness of LINC in increasing access to and engagement in mental health and non-mental health services among suicidal youth (N = 587). Other variables of interest included service use facilitators and service use barriers. Generalized linear mixed models with binomial distribution and logit link were performed to ascertain if service use facilitators and barriers were associated with service utilization and if disparities in service use and engagement existed between Black and White suicidal youth through a comparative analysis. Service utilization differences were found between Black and White youth. While Black and White youth were both likely to engage in individual therapy (OR = 1.398, p < .001) and non-mental health services (OR = 1.289, p < .001), utilization rates for mental health and medication management services were lower for Black (55.1% to 60.6%) youth compared to White (66.0% to 71.0%) youth. Specifically, Black youth were significantly less likely than Whites to receive medication management (OR = .466, p = .002). Systemic barriers such long waitlists for care (OR = 1.860, p = .039) and poor relationship with providers (OR = 7.680, p = .028) increased odds of engagement in non-mental health services. Clinical disorders and engagement in suicide-related behaviors increased the likelihood of obtaining care from both medication management and non-mental health services. Care coordination services for suicidal youth can increase access and engagement in mental health and non-mental health services. Culturally adapted models attending to cultural and social assets of Black families are needed to reduce disparities and suicide risk among Black youth.

Although more than one in 10 youth with Autism Spectrum Disorder (ASD) is admitted to a psychiatric facility before they reach adulthood, the inpatient population is underrepresented in research. Furthermore, Black youth are more likely to be psychiatrically hospitalized, compared to their White counterparts. Yet, prior research has been inconsistent in potential racial differences in ASD symptoms and severity. This study examined differences in the symptom presentation of psychiatrically hospitalized Black and White youth with ASD. Researchers collected data as part of a larger study of youth admitted to one of six US specialized inpatient psychiatric units between 2013 and 2017. We used bivariate and multivariate models to analyze the data. The study included 654 youth diagnosed with ASD, with an average age of 13 years. While bivariate analyses found that Black youth had lower written language and daily living skills and more impaired social affect and inappropriate speech, multivariate regression models suggested that overall ability level and age may be driving these differences. Specifically, the only variables that significantly predicted adaptive functioning (written language, daily living) and behavioral profiles (social affect, inappropriate speech) were verbal ability, IQ, and age. Race was not a significant predictor in any of the models. Cultural diversity and competency are vital to the identification and treatment of ASD clinical care. Thus, understanding the role race may play in early detection and accurate diagnosis is important to improving ASD identification, diagnosis, and treatment. Autism Res 2020, 13: 532-538. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examined differences in autism symptoms between Black and White youth in psychiatric hospitals. We found that while it initially appeared that Black and White youth differed in written language and daily living skills, these racial differences were not significant once we accounted for differences in IQ, age, and verbal ability. Our findings suggest that providers should pay greater attention to other potential reasons for racial disparities in autism services.

Suicide rates are increasing rapidly among Black children and adolescents, calling for novel approaches to understanding their unique risk factors. The Structural Racism and Suicide Prevention Systems Framework offers a new culturally responsive theory that structural racism is an underlying mechanism for disparities in suicide among ethnoracial marginalized youth. Thus, a deeper analysis of the intersection of racism and systems to better understand suicide risk and create more effective targeted interventions for Black youth is imperative. The current systematic review comprehensively evaluated and synthesized the empirical literature regarding the relationship between structural racism and suicide risk among Black youth. 17 studies from 3 database searches, published between 2013 and 2024 are presented. Results revealed a positive relationship between structural racism and suicidal thoughts and behaviors among Black youth. Systems that particularly facilitate the perpetration of racism toward Black youth include schools, criminal justice, and income inequality. Findings serve as a call to action to incorporate more socioecological models into suicide prevention research focused on Black youth. Understanding the depth and scope of how racism contributes to suicide risk provides key targets for prevention and intervention strategies that are specific to individuals belonging to this group at disparate risk for suicide.

Community-based youth mentoring programs are popular interventions that serve a large number of Black youths throughout the country. Interestingly, the majority of mentors who volunteer their time for mentoring organizations identify as non-Hispanic White. This study examines how White mentors address topics acknowledging ethnic/racial identity and issues centered around social justice and recognize their own privileges when mentoring Black youth in community-based youth mentoring programs. The aims of the current study were to examine: (a) whether and how White volunteer mentors address ethnic/racial identity, racial socialization, and oppression in the mentoring relationship and (b) how White mentors' awareness of their own positionality and privilege impacted how they addressed ethnic/racial identity, racial socialization, and oppression in the mentoring relationship with Black youth. Utilizing a constructivist grounded theory approach, in-depth semi-structured interviews were conducted with 26 current and former mentors from six different Big Brothers Big Sisters community-based mentoring programs across the United States. Findings reveal that some mentors felt uncomfortable discussing issues centered around race and others do not think it is relevant at all. Further, findings demonstrated that mentoring Black youth significantly impacts mentors' perceived awareness of social issues and acknowledgment of privileges they hold. Current findings highlight the need for youth mentoring programs to provide training and resources to help White mentors discuss implications of race and broader social justice issues with the Black youth they mentor.

When home reminds me of jail: The carceral nature of out-of-home care for Black youth in Ontario’s child welfare system

Historically, Black youth have had lower rates of suicide attempts in comparison to their peers; however, in recent years this rate has changed, with self-reported suicide attempts for Black adolescents rising by 73%. The purpose of this study was to analyze the characteristics of research on Black youth and suicide using bibliometric techniques. To conduct our analysis, we developed a search strategy utilizing the Scopus database for the time period from 1980 to 2020. Results indicated an increasing trend in the number of articles published each year related to Black youth and suicide. The most highly productive journals were the Suicide and Life Threatening Behavior, Pediatrics, and Journal of Youth and Adolescence. Authors who frequently published in this area include Nadine Kaslow, Rheeda Walker, and Sean Joe. While this research area is growing, there is a lack of published articles focused on interventions for suicide prevention and non-comparative race specific research focused on Black youth.

There is a lack of literature on the cultural adaptation of technologies for dementia care. This paper presents an example of the cultural adaptation of a television video about drinking water for older Chinese adults with dementia in care settings, in Vancouver, Canada. We refer to the cultural adaptation process (CAP) model to guide the cultural adaptation process by collecting and incorporating feedback from different parties into the culturally adapted video, including Phase 1 local consultations and information gathering, phase 2 iterative testing and adaptation, and phase 3 finalizing adaptation. We also referred to the Ecological Validity Model (EVM) to present the adjustments we made to the video from the cultural adaptation. We adjusted the video on seven domains suggested by the EVM: goal, context, content, language, people, concept, and method. We draw attention to the opportunities and challenges of the cultural adaptation of technology into a new community. Based on our lessons, we outline concrete suggestions about what aspects of, and how, cultural adaptation can be made to promote cultural inclusivity in technology development and implementation.

Although many youth experience difficulty in the school-to-work transition, increasing numbers of black youth face more chronic difficulties that have far-reaching developmental implications. This chapter examines both objective and subjective aspects of chronic joblessness among black youth, with emphasis on gender differences in discouragement over job searches and related developmental issues. A life cycle approach to role strain and adaptation provides a coherent framework to guide theoretical inquiry into jobless black youth in America. Role-strain adaptation processes have special appeal because they provide a coherent conceptual base for studies on the nature, antecedents, and consequences of chronic difficulty in job search. Two basic notions in the proposed role-strain adaptation approach to joblessness among black youth are that discouragement in the job search and self-blame increase the risk of maladaptive responses to objective barriers and that objective and subjective cultural resources facilitate adaptive response patterns. The role-strain adaptation paradigm not only provides a parsimonious framework but also builds on a diverse theoretical and empirical literature (Barnett, Beiner, and Baruch, 1987; Bowman, 1989; Goode, 1960; Kahn and others, 1964; Merton, 1968; Pearlin, 1983; Sarbin and Allen, 1968). Role-strain adaptation models allow one to go beyond past studies on black youth, which have primarily been descriptive rather than theoretical and predictive. In addition to the foregoing benefits, a major virtue of the life cycle approach to job search strain processes is its explanatory power throughout the life span (Allen and Vande Vliert, 1981; Erikson, 1980; George, 1980; Levinson and others, 1978). A life cycle framework avoids common misconceptions that occur with a narrow focus on job search strain among black youth that fails to consider the continuity in chronic role-strain adaptation processes. In a broader life-span framework, the interrelated concepts of human development and cultural adaptation have unique explanatory power. Elsewhere (Bowman, 1989) I have noted that to develop means to grow out of, to evolve from--where experiences at one life stage not only follow but emerge directly from preceding life experiences. The related concept of adaptation involves a continuing process of incorporating past experiences into new patterns to strategically meet the challenge of changing life demands without undue compromise. For black youth faced with chronic joblessness, effective adaptation may require preserving core cultural patterns from prior generations, while also transforming such core patterns into new strategies to cope with job search barriers in postindustrial America.(ABSTRACT TRUNCATED AT 400 WORDS)

BackgroundDigital mental health interventions leverage digital communication technology to address the mental health needs of populations. Culturally adapting interventions can lead to a successful, scalable mental health intervention implementation, and cultural adaptation of digital mental health interventions is a critical component to implementing interventions at scale within contexts where mental health services are not well supported.ObjectiveThe study aims to describe the cultural adaptation of a digital mental health intervention Step-by-Step in order to address depression among Chinese young adults.MethodsCultural adaptation was carried out in four phases following Ecological Validity Model: (1) stage setting and expert consultation; (2) preliminary content adaptation; (3) iterative content adaptation with community members; (4) finalized adaptation with community feedback meetings. Cognitive interviewing was applied to probe for relevance, acceptability, comprehensibility, and completeness of illustrations and text. Six mental health experts and 34 Chinese young adults were recruited for key informant interviews and focus group discussions.ResultsWe adapted the text and illustrations to fit the culture among Chinese young adults. Eight elements of the intervention were chosen as the targets of cultural adaptation (e.g., language, metaphors, content). Samples of major adaptations included: adding scenarios related to university life (relevance), changing leading characters from a physician to a peer and a cartoon (acceptability), incorporating two language versions (traditional Chinese and simplified Chinese) in the intervention (comprehensibility), and maintaining fundamental therapeutic components (completeness).ConclusionThis study showed the utility of using Ecological Validity Model and a four-point procedure framework for cultural adaptation and achieved a culturally appropriate version of the Step-by-Step program for Chinese young adults.

While youth generally experience stressors from developmental milestones, Black youth also face racialized stressors. Racial socialization has been found to help Black youth cope with racialized stressors, but research has yet to show its contribution to coping beyond general socialization practices. This study examines how racial socialization contributes beyond that of general coping socialization to coping behaviors. Fifty-eight third-eighth-grade (Mage =11.3, SD=1.54) youth reported general coping socialization and racial socialization practices and coping behaviors. Results indicate that for engagement coping, racial socialization messages contributed significantly to parent-provided engaged socialization strategies. Implications are considered for the ways in which Black youth experience stress and require culturally specific practices for successful coping with frequently encountered stressors.

Suicide risk assessment and prevention interventions in military veterans