Black Children Research Articles

Culturally Tailored Messages and Trial Registry Enrollment: A Randomized Clinical Trial.

Marginalized populations have lower levels of clinical trial representation than other populations. Tailoring recruitment materials and providing incentives may improve representation. To determine whether culturally tailored video improves parents' decision to enroll (DTE) Black children in a research registry. A randomized clinical trial, using mixed methods and consecutive sampling, was conducted in an urban primary care pediatric clinic. A post hoc study assessed the association of a monetary incentive with DTE. Ninety-three parents were recruited before their child's scheduled clinic visit. Participants completed a survey during which they were randomly assigned to review a paragraph (control group), generic video, or tailored video and received a gift card. Video watchers completed questions about its effectiveness. All participants were invited to join the registry. In the post hoc study, consenting participants followed the control group protocol and the coordinator promised them an ink pen for participating. The study was conducted between November 15, 2022, and August 29, 2023. A survey regarding the importance of being included in research studies was administered after participants watched a culturally tailored video. The primary outcome was DTE. Covariates were message effectiveness, clinical trial knowledge, and trust. Intention-to-treat analysis was performed. A total of 125 individuals were included. All groups had similar mean (SD) parent age (overall, 32.6 [7.35] years), gender (110 [88.0%] women), and race (116 [92.8%] Black or African American). There was no significant difference in the odds of DTE between the appeal video and control (odds ratio [OR], 1.19; 95% CI, 0.38-3.72) or between the generic video and control (OR, 1.91; 95% CI, 0.54-6.71). However, DTE was higher for all 3 gift card groups vs the ink pen incentive group (eg, control vs ink pen incentive: OR, 5.01; 95% CI, 1.68-14.95). After adjusting for trust, monetary incentives were associated with higher odds of DTE (adjusted OR, 5.92; 95% CI, 2.44-14.39). In this randomized clinical trial, targeted messaging was not associated with a higher decision to enroll in a pediatric clinical trial registry. There may be a role for combining holistic messaging with monetary incentives to improve enrollment. ClinicalTrials.gov Identifier: NCT06138145.

Race, Neighborhood Disadvantage, and Prehospital Law Enforcement Handcuffing in Children With Behavioral Health Emergencies.

Minoritized youth and children in resource-limited neighborhoods rely on emergency medical services (EMS) for accessing care, including during behavioral health emergencies (BHEs). Law enforcement (LE) officers sometimes use forceful tactics in such settings. Assessing LE actions is needed to ensure safe and equitable care for vulnerable populations. To examine whether race and ethnicity, neighborhood disadvantage, sex, and age are associated with LE handcuffing during pediatric BHEs. This cross-sectional study analyzed LE handcuffing, demographic factors, and neighborhood disadvantage in Alameda County, California. The study population included children younger than 18 years who were evaluated by EMS for BHEs between January 1, 2012, and June 30, 2019. Data analysis was completed between January 1, 2022, and August 30, 2023. Primary exposures included race and ethnicity and Area Deprivation Index (ADI) rank as ADI I (1-3 [lowest]), ADI II (4-6 [moderate]), and ADI III (7-10 [highest]). The primary outcome was LE handcuffing during BHEs. The study calculated handcuffing proportions stratified by race and ethnicity, ADI, and sex. The final dataset consisted of 6759 pediatric BHE encounters with complete data. Among these, 3864 encounters (57.2%) were with females. The median age was 14.9 (IQR, 13.4-16.2) years. Overall, LE handcuffing occurred in 517 encounters (7.6%); Black children had higher odds than their White peers (adjusted odds ratio [AOR], 1.80; 95% CI, 1.39-2.33). Compared with low neighborhood disadvantage, moderate neighborhood disadvantage was independently associated with increased odds of handcuffing (ADI II: AOR, 1.51; 95% CI, 1.21-1.88), as was highest neighborhood disadvantage (ADI III: AOR, 1.54; 95% CI, 1.19-1.99). Male sex (AOR, 2.31; 95% CI, 1.91-2.79) and age (AOR per 1-year increase, 1.15; 95% CI, 1.10-1.21) were also associated with increased odds of handcuffing. In moderately disadvantaged neighborhoods, the odds were higher for Black children (AOR, 2.52; 95% CI, 1.65-3.86). When stratified by sex, the odds of handcuffing were significantly higher for Black females compared with White females (AOR, 2.59; 95% CI, 1.69-3.98). The findings of this cross-sectional study suggest that accessing EMS for BHEs may expose Black children and youth in disadvantaged neighborhoods to LE use of handcuffing. Emergency medical services should reconsider the role of LE officers in these settings.

A Multicomponent Preventive Intervention in the Early Elementary Years: A Look at Academic and Social Adjustment Outcomes.

Cogent indicated prevention with young children at risk for early onset conduct problems needs to address multiple domains of influence in school and home settings. A multicontextual preventive intervention (MPI) spanning grades one and two was conducted in schools serving economically disadvantaged communities and evaluated separately for boys and girls. The cluster randomized design evaluated children nested within schools receiving either the MPI (6 schools), which consisted of after-school reading-mentoring, home-based family, peer coping-skills, and classroom components, or a control condition (6 schools) involving a school-wide conflict management program without targeted intervention. Drawn at the end of kindergarten based on elevated behavioral difficulties and first-grade attendance at one of the 12 schools, the two subsamples consisted of 193 boys and 171 girls (63% in households with annual income < $15,000; 95% Black children). Extensive fidelity data indicated that the MPI components were well implemented. The two post-intervention third-grade outcomes in this report are academic performance and social/behavioral adjustment. The analyses involved a linear mixed effects model controlling for school. The key finding for the male subsample was that the MPI produced greater overall and language-arts/reading achievement, measured by report cards for the entire third-grade school year, compared with the control group. MPI-control differences did not emerge for externalizing problems and social competence assessed via teacher and parent report. In the face of elevated risk and poverty, the study underscored the importance of contributions from community-based reading-mentors, positive and inclusive classrooms, and nurturing family contexts in achieving academic gains.

“Doin’ diversity” in teacher education: beginning Black teacher discourses on learning to teach for diversity

The voices of Black preservice teachers are largely missing from discussions about teacher diversity, and one place this is evident is in teacher education diversity coursework. This article shares findings from a qualitative study using critical race methodology with five novice Black teachers’ experiences in teacher education courses focused on diversity in education. Three semi-structured life history interviews were conducted for each teacher and data were analyzed using zoom model analysis. Findings revealed that during their preservice experiences in teacher education diversity courses, Black teachers experience such learning spaces in alienating ways despite entering the program with strong commitments to improving education outcomes for Black children. Findings demonstrate that teacher educators and teacher education programs must raise the expectations for engaged learning in the diversity course in order to better support Black teachers and contribute to diversification of the teaching force in meaningful ways.

PREJUDICE AND DISCRIMINATION IN EARLY CHILDHOOD EDUCATION: IMPACT ON IDENTITY FORMATION

This article aimed to understand the contribution of black social movements in defense of the decolonization of the school curriculum, and consequently for the teaching of African and Afro-descendant history and culture, from the perspective of black people and not of the colonizers. In this sense, it analyzes the changes that have been occurring since Law 10.639/03 and Law No. 11.645/2008, a legal framework for the policy that indicates the mandatory inclusion of the theme of Afro-Brazilian, African and indigenous history and culture in basic education. The study pointed out stereotypes suffered by black children in preschool classes, by their peers and teachers, and the impacts of racism in the form of prejudice and discrimination in the formation of the identity of black children. It also pointed out possibilities for interventions based on legal contributions such as security of rights.

Intra- and intergenerational food insecurity: An analysis of Black and White women and children from the NHLBI Growth and Health Study

BackgroundFood insecurity (FI) continues to be a significant public health concern and is associated with myriad physical and mental health consequences. Increased understanding of conditions around its occurrence throughout the life course are needed. However, research has been limited due to inadequate measurement tools and study length. ObjectiveThis study examined the intra- and intergenerational dynamics of FI over time by assessing the transmission of FI from childhood to adulthood, and from mother to offspring using population-specific FI measures, and the influence of sociodemographic factors. MethodsWomen in early midlife (n=624) and their children (n=331) participated in a prospective cohort study between 1987-2019 in Richmond, California. Three validated FI measures were assessed, representing 1) past childhood FI and 2) current adult household FI, reported by the women, and 3) current child FI, reported by the women’s children. Associations between measures were examined using adjusted modified Poisson regression models. Mediation by current adult household FI between past childhood FI and their offspring’s current child FI was assessed. Moderation by sociodemographic factors, including poverty level, parental education, marital status, and race was also assessed. ResultsAmong women, 32.4% reported FI in childhood and 34.5% reported current adult household FI. Among their offspring, 53.2% reported current child FI. Past childhood FI increased the likelihood of current adult FI (RR: 2.18, 95%CI: 1.64, 2.90) and current adult FI increased the likelihood of current child FI (RR:1.49, 95%CI: 1.08, 2.07). Current adult FI partially mediated past childhood FI and their offspring’s current child FI (Natural indirect effect: 1.42, 95%CI: 1.03, 2.24). There was no evidence of moderation by sociodemographic factors. ConclusionsFI measures reported by adults and children capture differing experiences, highlighting the need to use FI measures that are appropriate for their target population. FI may be perpetuated intra- and intergenerationally.

The Maternal Body, HIV and Race: Dual Raced and Ambivalent Maternal Experiences in a Vertically Infected HIV-Positive Adolescent

The HIV pandemic in South Africa has tragically left a wake of vertically infected children who have suffered parental loss and social marginalization. Vertically infected HIV-positive children are those who have acquired the virus from their mother during pregnancy, childbirth, or breastfeeding. In this paper, the development and alienation of the self is explored in a psychoanalytically informed research case study of a black adolescent girl who was vertically infected with HIV and later fostered by a white mother. This case study explores the sociogenic meanings of raced maternal experiences and disease identified in a series of psychoanalytic interviews, using interpretive phenomenological analysis. Drawing from Melanie Klein, Franz Fanon and other feminist and post-colonial psychoanalytic theorists, the early primal raced and diseased scene is considered through internalizations and fixation on the body. Nosipho is first introduced through a short vignette and a discussion of her early maternal relational experiences. The paper then explores the ambivalence experienced by the participant as part of her HIV and raced lived experiences. HIV and raced subjectivities are both powerful internalized conscious as well as unconscious embodied experiences. For Nosipho, it has been a complicated process found in the shared dual mothering experiences between a biological mother who is black and the subsequent white maternal experiences. The interrogation of this embodied dual experiences of having black mothers who are HIV-positive whilst simultaneously having white mothering roles in children who are vertically infected with HIV is a terrain that is infused by deep contradictory and conflicting emotional and affective states around love and hate, joy and despair, fear, and hope, all at once. Consequently, holding both the HIV and the raced subjectivities is deeply painful for black children who are vertically infected with HIV.

Sociodemographic Disparities in 1-Year Outcomes of Children With Community-Acquired Acute Kidney Injury

Racial disparities have been identified in pediatric community-acquired acute kidney injury (CA-AKI), and they are associated with increased risk of child mortality, morbidity, and progression of kidney disease. To assess clinical outcomes at 1 year among children with CA-AKI, stratified by age, race, and ethnicity. This retrospective cohort study is a population-based analysis of deidentified, aggregated electronic health record data collected by 61 large health care organizations from 2003 to 2023 and accessed through the TriNetX platform. Outcomes were assessed at 1 year after a CA-AKI episode. Participants included pediatric patients (aged <18 years) with AKI. Data were accessed in January 2024. A diagnosis of CA-AKI and sociodemographic factors such as race, ethnicity, and age, as reported in electronic health records. The primary end point of this study was to assess differences in clinical outcomes within 1 year of an episode of CA-AKI, including all-cause emergency department (ED) visits, intensive care unit (ICU) admissions, mechanical intubation and ventilation, and mortality. Risk was compared between White children and Asian (including Asian, Native Hawaiian, and Other Pacific Islander), Black, and Hispanic children, stratified by age group. Measures of association, Cox proportional hazard analyses, and Kaplan-Meier survival curves were performed within the TriNetX Advanced Analytics Platform between racial and ethnic groups for each analysis. From the total sample of 18 152 children, those with hospital-acquired AKI, chronic kidney disease, end-stage kidney failure, or dialysis dependence were excluded, leaving a final cohort of 17 125 children (mean [SD] age, 11.2 [5.2] years; 9424 male [55.3%]). Eligible patients were divided into racial and ethnic groups as follows: non-Hispanic Asian, 1169 children (6.5%); non-Hispanic Black, 4636 children (27.3%); Hispanic, 1786 children (10.2%); and non-Hispanic White, 9534 children (55.9%). Patients were further subdivided into groups aged 0 to 9 years (546 Asian children, 1675 Black children, 689 Hispanic children, and 3340 White children) and 10 to 18 years (623 Asian children, 2961 Black children, 1091 Hispanic children, and 6104 White children). Within 1 year of CA-AKI diagnosis, compared with White children, Black children experienced greater rates of ED visits (hazard ratio [HR], 1.53; 95% CI, 1.40-1.67), ICU admissions (HR, 1.31; 95% CI, 1.16-1.47), mechanical ventilation (HR, 1.33; 95% CI, 1.13-1.56), and all-cause mortality (HR, 1.27; 95% CI, 1.09-1.48), as well as the greatest risk for composite outcomes (HR, 1.43; 95% CI, 1.33-1.53). Hispanic children experienced greater rates of ED visits (HR, 1.40; 95% CI, 1.21-1.62) and the greatest risk of all-cause mortality (HR, 1.66; 95% CI, 1.31-2.09), whereas Asian children experienced greater rates of mechanical ventilation (HR, 1.69; 95% CI, 1.26-2.27), compared with White children. Black and Hispanic children aged 0 to 9 years were at greatest risk of experiencing poor clinical outcomes. Black children had a 11.41% lower survival probability and Hispanic children had a 7.14% lower survival probability compared with White children after an initial ED encounter. Among children with an identified episode of CA-AKI diagnosed in an ED, within 1 year, Black and Hispanic children had a poorer survival probability compared with White children. Future studies are needed to understand these disparities and improve awareness and follow-up after emergency care.

Experiences of discrimination and snacking behavior in Black and Latinx children.

Little is known about how discrimination contributes to health behaviors in childhood. We examined the association between children's exposure to discrimination and their snacking behavior in a sample of youth of color (N = 164, Mage = 11.5 years, 49% female, 60% Black, 40% Hispanic/Latinx). We also explored whether children's body mass index (BMI) or sleepiness moderated the association between discrimination and calorie consumption. The significant link between discrimination and calorie consumption was moderated by children's BMI, such that discrimination was associated with calorie consumption for children with BMI percentiles above 79%. Children's sleepiness did not serve as an additional moderator. Efforts to promote health should consider children's broader socio-contextual experiences, including discrimination, as factors that may shape eating patterns.

Black Caregiver Perspectives During a Developmental Diagnostic Interview.

Despite increasing autism prevalence rates across racial and ethnic groups, research has traditionally overlooked the influence of culture on developmental diagnostic conversations. Addressing this gap in research is crucial to understanding and mitigating potential disparities in diagnostic experiences, especially among Black caregivers. Black caregivers encounter frustration and discrimination during the diagnostic process, citing dismissiveness and a lack of cultural competence from healthcare providers. To address these issues, this study centers the perspectives of Black caregivers as they participate in a developmental diagnostic program for toddlers under three years of age. This retrospective qualitative study, conducted exclusively by a Black research team, involved nineteen Black caregivers of thirteen toddlers as they participated in semi-structured interviews conducted by a multidisciplinary clinical team. The research team employed a conceptual content analysis to examine caregivers' descriptions of their children's behaviors and characteristics, as well as the factors and experiences associated with their descriptions. Caregivers provided distinct descriptions of behaviors and characteristics in the categories of language and communication, learning, and temperament, associating them with situational and dispositional factors and experiences. The findings offer valuable insights for implementing culturally responsive diagnostic practices. Additionally, these results may enhance the quality of caregiver-provider interactions during developmental assessment, leading to earlier and more accurate diagnoses for Black children.

Changes in BMI prior to and during the COVID-19 pandemic among children: a retrospective cohort study in San Francisco, CA

BackgroundThe COVID-19 pandemic led to dramatic changes in the lives of children that impact cardiometabolic health. Cities and counties had varying policies with respect to school closure, recreational programs, and efforts to mitigate food insecurity and economic distress. Our objective was to evaluate changes in BMI-z score and prevalence of overweight/obesity prior to and during the pandemic among children in San Francisco, CA, where public schools were closed for 18-months.MethodsThis was an electronic medical record-based retrospective cohort study. We included 15,401 children, 4–17 years of age at study onset. Our exposure was time into each of three time periods: (1) March 2018-February 2019; (2) March 2019-February 2020; (3) March 2020-August 2021 (the pandemic period of school closure). Generalized estimating equations (GEE) were used to assess changes in BMI-z score and overweight/obesity across the three time periods. We assessed for effect modification by age-category, insurance status, and race/ethnicity.ResultsMean BMI-z score increased by 0.06 per year in time period 2, the year prior to the pandemic (p < 0.001, 95% CI: 0.04, 0.09), and by 0.12 per year during time period 3, the first 18 months of the pandemic (p < 0.001, 95% CI 0.10, 0.13). The proportion of children with overweight/obesity increased by 1.4% points per year during time period 2 (p = 0.012, 95% CI: 0.03, 2.46) and by 4.9% points per year during the first 18 months of the pandemic (p < 0.001, 95% CI: 4.11, 5.67). The effect modification analysis demonstrated that the youngest age group, publicly insured children (versus privately insured), and Black, Latino, and Asian children (versus White children) experienced greater increases in BMI-z score during the pandemic (p < 0.01 for all comparisons). The youngest age group (p = 0.022) and publicly insured children (versus privately insured children) (p < 0.001) also experienced greater increases in the proportion of children with overweight/obesity during the pandemic.ConclusionsAmong children in San Francisco, increases in BMI-z score and overweight/obesity were greater during the pandemic compared to prior changes, with the most pronounced increases among younger and publicly insured children. These findings support the need for more targeted and effective policies for addressing childhood overweight/obesity, especially among these high-risk populations.

Our grief matters – loss, grief, and mourning in Black vertically infected HIV-positive adolescents

Within the South African context, psychoanalysis as praxis and research has not located itself outside of the country’s long, violent, and oppressive socio-political past. A major area in which psychoanalysis continues to demonstrate a deficit is in its lack of attention to race as constitutive of psychological development and a site of intense psychological pain. A further area that is often overlooked in both the theory and praxis of psychoanalysis in South Africa is the diseased body as a site of socio-political violence and oppression, and the subsequent impact of this trauma on intrapsychic development. This situation is particularly applicable in the development of Black children who are vertically infected with HIV. The focus of this article, the fourth in a series of five articles, is on the process of grief and mourning in three vertically infected HIV-positive adolescents. Findings indicate that children who are vertically infected with HIV suffer multiple losses leaving them with intense unprocessed grief despite having access to individual therapy. In addition, their raced subjectivities add to experiences of non-being leading to grief which remains minimised and overlooked within the psychoanalytic canon, keeping the mourning process hidden in historically oppressive systems as melancholia.

Preconception and prenatal vitamin D associations with positive behavioral health in Black children.

Low levels of vitamin D during pregnancy are associated with offspring behavioral problems but little is known about pre-pregnancy influences. Additionally, Black American individuals are underrepresented in studies, limiting translational impact. We tested independent and interactive effects of preconception and prenatal vitamin D in Black women in relation to positive behavioral and emotional outcomes in early childhood. Black-identifying participants (N = 156) enrolled in the longitudinal Pittsburgh Girls Study (PGS) provided venous blood samples before and during pregnancy to measure 25-hydroxyvitamin D (25[OH]D) levels. Participants completed questionnaires assessing sociodemographic factors, depression severity and life stress, and later reported on child behavioral and emotional problems and prosocial behavior between 2 and 4 years. Mean serum 25(OH)D concentrations were 15.5 ng/ml (s.d. = 7.7) before pregnancy and 18.0 ng/ml (s.d. = 9.2) during pregnancy; below the sufficiency threshold according to commonly used dietary guidelines. After adjusting for covariates, prenatal 25(OH)D was negatively related to behavior problems and positively related to prosocial behavior in children, although the association attenuated for behavior problems after accounting for preconception 25(OH)D, which may reflect patterns of stability. Maternal 25(OH)D was unrelated to child emotional problems, and no synergistic effects of 25(OH)D timing were observed for any child outcome. Findings have relevance for Black women living in the northeast U.S. Results suggest specific associations between maternal vitamin D and positive behaviors in early childhood, regardless of sufficiency levels and suggest potential opportunities for early interventions to support healthy child development.

Child Separation and the Stolen Generation of Brazil: Indigenous Peoples’ (Un)Freedom in Amazonia

Abstract This article examines questions pertaining to Indigenous people’s citizenship status, the problematic definition of orphanhood, rule of law, and structural racism in Brazilian society. The definition of orphanhood was articulated in a way that allowed for the extralegal abuse and racialized exploitation of labor to continue long past the legal end of Indigenous slavery (1755). Indigenous persons’ legal status, the definition of orphanhood, and guardianship laws worked together to legitimate the permanence of child separation as a means for wealthier Brazilians to get free child labor. The article uncovers the ambiguities in defining Indigenous people’s legal status, making citizenship status a subjective determination contested on a case-by-case basis. With this foreground understanding, the article presents the practice of child separation and the created discourse to legitimize Indigenous, Black, and mixed-race children as unpaid criadas de casa (housemaids).

Associations of Neighborhood Food Retail Environments with Weight Status in a Regional Pediatric Health System.

Background: There have been mixed findings on the relationships between childhood obesity and macroscale retail food environments. The current study investigates associations of the neighborhood retail food environment with changes in children's weight status over 6 years in the Kansas City Metropolitan area. Methods: Anthropometrics and home addresses were collected during routine well-child visits in a large pediatric hospital (n = 4493; >75% were Black or Latinx children). Children had measures collected during two time periods ([Time 1] 2012-2014, [Time 2] 2017-2019). Establishment-level food environment data were used to determine the number of four types of food outlets within a 0.5-mile buffer from the children's residence: supermarkets/large grocery stores, convenience stores/small grocery stores, limited-service restaurants, and full-service restaurants. Children who moved residences between periods were "movers" (n = 1052). Associations of baseline and changes in food environment status with Time 2 weight status were assessed using mixed-effects models. Results: Movers who experienced no change in the number of convenience stores or small grocery stores within a 0.5-mile of their home had increased likelihoods of having overweight/obesity and less favorable BMIz changes, compared with movers who experienced a decrease in convenience stores/small grocery stores within a 0.5-mile distance. No associations were observed among nonmovers. Conclusion: Findings suggest that moving to an area with fewer unhealthy retail food outlets (e.g., convenience stores) is associated with a lower risk of obesity in children. Future research is needed to determine whether larger-scale changes to the retail food environment within a neighborhood can support children's healthy weight.

Visualizing Race at the Perkins School for the Blind

The article considers the construction of racialized citizenship in the Perkins School for the Blind in the nineteenth century through centering two cases of Black children that appear in Perkins’s archives. There is little scholarship on the history of Black students at Perkins, and materials on their experiences are scarce. Drawing on Saidiya Hartman’s concept of “critical fabulation,” the article speculates on how Black children were admitted to the institution not for training in economic futures but to serve as object lessons for their white classmates, who were taught to apprehend race through Black children’s presence. Black children helped produce white citizenship; the school’s ostensible policy of colorblind admission segregated blind Black children from futures preserved for blind white children. Illuminating presences and absences of race in the archives shows us how race, disability, and racialized disability co-constituted one another in the service of state-sanctioned efforts to manage who could and could not participate in the social, political, and economic orders.

Community Health Workers Linking Clinics and Schools and Asthma Control

Childhood asthma is characterized by pervasive disparities, including 3-fold higher hospitalization rates and 7-fold higher death rates for Black children compared with White children. To address asthma disparities, one must intervene in all lived environments. To determine if a community health worker (CHW) intervention to connect the primary care, home, and school for low-income minoritized school-aged children with asthma and their caregivers improves asthma control. This study was a hybrid effectiveness/implementation trial using a 2 × 2 factorial, cluster randomized clinical trial design of 36 schools crossed with participant-level randomization into a clinic-based CHW intervention. The study was conducted from May 2018 to June 2022. The intervention took place in primary care offices, homes, and 36 West Philadelphia, Pennsylvania, public and charter schools. Children aged 5 to 13 years with uncontrolled asthma were recruited from local primary care practices. Asthma management, trigger remediation, and care coordination occurred in school, home, and primary care settings. Children were followed up for 12 months. The Yes We Can Children's Asthma Program, Open Airways For Schools Plus, and school-based asthma therapy were implemented. Improvement in asthma control, as measured by the Asthma Control Questionnaire, comparing the mean difference between groups 1 year after randomization with their baseline (difference in differences). Both primary care and school interventions were dramatically disrupted by the COVID-19 pandemic; therefore, stratified analyses were performed to assess per-protocol intervention efficacy before the pandemic disruptions. A total of 1875 participants were approached, 1248 were excluded, and 1 was withdrawn. The 626 analyzed study participants (mean [SD] age, 8.7 [2.4] years; 363 male [58%]) self-identified as Black race (96%) and non-Hispanic ethnicity (98%). Although all groups had statistically significant improvements in asthma control from baseline to 12 months (P- group: -0.46; 95% CI, -0.58 to -0.33; P+ group: -0.57; 95% CI, -0.74 to -0.44; S- group: -0.47; 95% CI, -0.58 to -0.35; S+ group: -0.59; 95% CI, -0.74 to -0.44), none of the difference-in-differences estimates from the primary prespecified models showed a clinically meaningful improvement in asthma control. Analysis from the prepandemic interval, however, demonstrated that children in the combined clinic-school intervention had a statistically significant improvement in asthma control scores compared with control (-0.79; 95% CI, -1.40 to -0.18). This randomized clinical trial provides preliminary evidence that connecting all lived environments for care of children can be accomplished through linkages with CHWs.

Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial

BackgroundEarly intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People’s Health Partnership (CYPHP) model of care uses...

Mother of All Labour: Vulnerability and Immunity in Times of Ebola

Wonkifong Ebola treatment unit was unique at the time of the outbreak that hit the Guinea in 2014. Contrary to other infrastructures run by Western workers, Wonkifong mainly employed personnel from Guinea, the Democratic Republic of Congo, and Cuba. Even so, the unit constituted a racialised landscape where proximity to white agencies granted privileges to certain groups of racialised people while excluding others. In a humanitarian infrastructure aimed at empowering knowledge of epidemics in the Global South, Black children were quarantined without their parents and left mostly unattended. After many months, former patients were hired as nannies to remedy the infrastructure’s blind spot. These women were employed to care for the children thanks to their immunity to the virus. Building on the concept of a ‘politics of life’ and exploring how these women were exploited as ‘medical superbodies’, my article sheds light on how the humanitarian infrastructure produced a gendered labour that mirrors other economies exploiting female Black bodies such as the colony or the plantation. Relying on an ethnography of practices of care and mobility within the unit, this piece underlines how the postcolonial segregation at play during the outbreak operated not strictly in terms of skin colour, but in terms of gender and closeness to white power.

Introduction to the Special Issue: The Lives (and Futures) of Black Children and Youth

Abstract As social science scholarship on Black children and youth continues to expand and to explore their experiences, there remains a need to investigate how families, communities, relationships, and social institutions impact their experiences. The theme for this special issue is inspired in part by our consideration of Black children’s and youths’ present realities and their futures. The editors of this volume are interested in creating space to analyze and theorize the radical possibilities for Black children to flourish in a world that typically ignores, marginalizes, and dismisses their plights and their promise. Privileging the agency of Black youth, the articles in this special issue provide nuanced accounts of how they make sense of many aspects of their lives and futures.