Black Families Research Articles

Neighborhood assets, parenting, and child disruptive behavior in low-income black families.

Neighborhood assets, such as access to recreational facilities, density of residence, and safety, were examined in relation to parenting and disruptive behavior in early childhood. Examining data from a low-income Black preschool sample, this study investigated how self-reported neighborhood assets and observed parenting behaviors interactively predict observed disruptive behavior in children. Findings revealed a significant relationship between parenting and child behavior, where parenting with high sensitivity and engagement and parenting with less verbal and physical interference and intrusiveness predicted fewer child disruptive behaviors. There was also a significant interaction between neighborhood assets and parenting behaviors on child disruptive behavior, in which nonoptimal parenting behaviors predicted child disruptive behaviors to a greater degree in neighborhoods with fewer assets. On the other hand, optimal parenting was protective of child outcomes under conditions of fewer assets, above and beyond parenting in neighborhoods with greater assets. Few studies have examined this complex relationship between the neighborhood, parenting, and child disruptive behavior with the use of self-report and observational measures utilized in this study. Furthermore, few studies have examined this relationship within such a high-risk preschool sample. Given these findings, there is a need to improve neighborhoods to better support families. Additionally, clinicians may need to be more attentive to the effects of parenting and neighborhood assets on disruptive behavior in early childhood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rehistoricizing Black Masculinity in The Wonder Years Reboot

Popular entertainment remains one of the last places where Black history lives on despite the recent political erasure of U.S. Black struggles. The 2021 reboot of The Wonder Years, reframing Black masculinity through the young eyes of main character Dean Williams, rehistoricizes modern notions of Black families in the post-Civil Rights Movement. The purpose of this study is to explore Black masculinity media representations within reboot culture as a means to rehistoricize Black struggle and civil rights. Based on discourse analysis, the authors found the following three discourses: Reimagining Black Excellence, Recontextualizing Black Masculinity, and Revisiting Respectability Politics.

“Livonia is just all racism”: locating black families’ racial and spatial experiences, school choices, and educational agency in metropolitan Detroit

ABSTRACT Focusing on the metropolitan Detroit region, this paper examines how seven Black families’ racial and spatial subjectivities influenced their suburban school and community choices, and more broadly their acts of educational agency. Using a critical phenomenological approach, key findings show that families’ lived experiences of race and racism in the region, along with the increased presence and support of Black students, families, and educators in select suburban schools influenced their choices and efforts to make suburban schools aligned with their educational and communal priorities, revealing the dual nature in which Black families navigate unjust U.S. education landscapes. Implications address the ongoing challenges Black families encounter in U.S. regional education landscapes and the need for more just approaches that honor Black families’ educational agency and placemaking in local contexts.

Missed Opportunities for Intervening Early in Preschoolers with Developmental Concern: Perspectives From Head Start Parents, Teachers, and Healthcare Providers.

The purpose of this study was to discover the care meanings of facilitators and barriers to detection and intervention for developmental delay among Head Start preschool-aged children, as viewed by parents, teachers, and primary care providers. We used a qualitative focus group design and broad cultural lens to understand similarities and differences in family and professional care, as Head Start programs educate preschoolers living in poverty who are disproportionately from ethno-racial minoritized groups. We sought the perspectives of 15 Head Start parents equally representing Black, Latino(a), and White parents, 17 teachers, and 11 healthcare providers to discover facilitators and barriers to adherence with professional recommendations. We found that silos in professional communications, parent distrust, knowledge deficits, and stigma were barriers to obtaining developmental recommendations. Participants also identified missed opportunities to facilitate interagency coordination, parental advocacy of a child's developmental needs, and professional alliances to take collaborative actions for early identification and treatment. Furthermore, a subculture of poverty adversely influenced adherence to developmental recommendations, and ethno-racial biases affected Black and Latino(a) families' follow-through. Our findings highlight how the lack of coordination between sectors resulted in the dismissal of parental concerns or denial of services by 1 system or the other, thus, at the very least reducing the child's chances for earlier intervention and treatment. We also identified potential benefits to children when the barriers of poverty and ethnoracial bias are addressed by professionals with coordinated actions, and new systems are developed for sharing developmental screening results and partnering to coordinate care across the preschool and primary healthcare settings.

Multisystemic Resilience and Anxious-Depressed Symptoms in Black Youth Exposed to Maternal Syndemics: A Mixed-Method Study.

We explored associations between multisystemic resilience and anxious-depressed symptoms in Black families experiencing maternal syndemics (i.e., co-occurring epidemics of substance abuse, violence, HIV/AIDS), using a sequential explanatory study design. Hierarchical regression was used to analyze data from 171 Black youth (57% girls; Mage=12.13, SD = 2.90). Girls (β=-0.17, p = .02) with higher inter/intrapersonal skills (β = - 0.28, p = .004) and more open familial communication (β = - 0.40, p < .001) reported fewer anxious-depressed symptoms, F(12, 147) = 5.68; p < .001, Adj R2 = 26.1%. Qualitative results from a subsample of 10 Black youth-mother dyads explored inter/intrapersonal factors (i.e., emotion regulation strategies, goal setting, persistence and perseverance, problem-solving skills) and open communication factors (i.e., comfortable environment to talk, solving problems, processing feelings, showing affection, benefiting from open communication) that support Black youth resilience. Findings highlight key resilience factors that could be bolstered in future interventions to reduce anxious-depressed symptoms among Black youth exposed to maternal syndemics.

"It Isn't What I Had to Do, It's What I Get to Do": The Experiences of Black Family Caregivers Managing Dementia.

Black family caregivers of persons with dementia experience high levels of stress that can negatively affect caregiver health outcomes and reduce caregiving capacity. However, Black caregivers tend to report low levels depressive symptoms or other negative health effects. This qualitative descriptive study aimed to identify factors that contribute to resilience among Black family caregivers. Using the rigorous and accelerated data reduction (RADaR) technique to complete thematic analysis, a team of five coders examined transcript data from three focus groups of Black current and former family caregivers (n = 17) of persons with dementia. We identified three primary factors that contributed to caregiver resilience including access to supportive environments, adaptability, and planning skills. Caregiver resistance to reporting depressive symptoms may be attributed to the strong Black woman schema. Findings from this study may be used to develop future culturally responsive interventions that support caregivers and promote family health.

Story Circles of Black Doulas, Cultural Brokers for Birthing People in Healthcare.

Doula care services (in-person, hybrid, and virtual) during the COVID-19 pandemic may vary. The purpose of this study was to explore doulas' experiences as birthing professionals and epistemological resources assisting Black birthing families during the pandemic. Virtual qualitative story circles were conducted with 11 Black doulas who attended births as doulas from January 2020 to December 2021. Participants were recruited in California. The story circles were audio recorded and transcribed verbatim. Transcripts were analyzed using content analysis, with attention to the influence of epistemic injustice (types of injustices inflicted on marginalized groups) on service provision. Additionally, we employed Patricia Hill Collins' Black Feminist Theory which describes "Black women's ways of knowing" that disrupts and challenges existing epistemologies. Narrative data revealed (1) doulas are positioned as possessors of epistemic influence in birthing spaces with intersecting social identities, (2) a pervasive oppression of doulas' knowledge, (3) epistemological resilience and disruption, and (4) a commitment to Black indigenous practices. Despite these epistemic unfair structures, systems, and experiences, Black doulas reimagine and establish pathways for birthing families to navigate the healthcare system during intrapartum care.

Impact of family engagement on client participation in coordinated specialty care for first episodes of psychosis

BackgroundCoordinated specialty care (CSC) programs for first episodes of psychosis are increasingly offered in the United States. A component of CSC programs is active family engagement in treatment, though research on the impact of this engagement is limited. This study examined the characteristics of families engaged compared to families not engaged in treatment, and the impact of family engagement on client participation and medication adherence over the first 6 months of treatment.MethodsUsing data from the Early Psychosis Intervention Network (EPINET) research hub in Minnesota (EPI-MINN), we compared two groups of individuals: clients who had a family member(s) engaged in their treatment vs. clients who did not. Family engagement was defined as any treatment services provided to a family member(s) by CSC clinical staff. The groups were compared on intake demographic variables, duration of untreated psychosis (DUP), hospitalizations, symptom severity, and functioning. A comparison of the total number of treatment visits during the first 6 months of treatment was tested using both nonparametric (Mann Whitney U) and parametric (ANCOVA) tests. Group comparisons on self ratings of “intent to attend visits,” “intent to complete the program,” and medication adherence were tested with ANCOVA and Chi-Square.ResultsFamily-engaged clients were younger, with less years of education, and more often White; clients without family engagement were more often Black. Family engagement was positively associated with increased total number of visits for all interventions with the exceptions of client peer support and case management visits. Family engagement increased clients’ self-reported intent to attend visits, though not intention to complete the program, which was moderately to markedly high in both groups. No differences were noted with medication adherence, with high rates of adherence across the entire study sample.ConclusionsOverall, results of the study support the benefits of family engagement in CSC on client participation, though future research is needed to understand why Black families are less engaged and what treatment adaptations are needed to reduce these racial differences. The results also support the value of CSC programs for medication adherence, a critical factor in symptom reduction and mental health recovery.

Social workers’ perspectives on anti-Black racism and parenting outcomes for incarcerated pregnant women with substance use histories

Summary Black women who use substances face significant barriers to accessing resources and parenting their children, largely as a result of interactions with the criminal legal, child welfare, and healthcare systems. While extensive literature has demonstrated how structural racism and punitive policy approaches underpin the operation and impact of these systems, minimal attention has been paid to how social workers approach child, maternal, and family well-being when interacting with clients who use substances and have been incarcerated. To address this gap, we conducted semi-structured qualitative interviews with 19 social workers practicing in jail/prison, community, and hospital settings across the United States. Findings Interviews identified the cyclical and intergenerational nature of harms perpetuated through criminal legal, child welfare, and healthcare systems. Participants described structural racism, inadequate resources (i.e., housing), and previous criminal legal and child welfare involvement as compounding barriers to an individual’s ability to parent and maintain recovery, particularly among Black families. Participants described the pervasiveness of structural racism but did not perceive themselves as active participants in perpetuating racist and oppressive structures. Applications Social workers engage with Black pregnant women who use substances across diverse practice settings and as such have the potential to both contribute to systemic harms and to champion interventions that target the root causes of inequity. Study findings support structural interventions that dismantle punitive systems and re-center the needs of Black communities, thereby supporting Black mothers in their fundamental right to parent their children.

Black Clinicians' Perceptions of the Cultural Relevance of Parent-Child Interaction Therapy for Black Families.

Parent-child interaction therapy (PCIT) is a highly efficacious, evidence-based treatment for children with disruptive behaviors and their families. PCIT is a dyadic therapy designed to improve parent-child relationships and decrease children's behavioral problems. PCIT research specific to Black families is currently sparse. Given findings that Black families have a higher attrition rate and demonstrate fewer significant improvements in parental well-being outcomes, we sought to assess clinicians' perceived cultural alignment of PCIT with Black families. We conducted individual interviews via Zoom with 10 Black clinicians, trained in PCIT, who had experience treating Black families using PCIT. The research team generated the following themes using thematic analysis: cultural misalignment, manualization, barriers to treatment, generational patterns of discipline, racial considerations, and protocol changes. Findings indicate that Black clinicians have identified various points of cultural misalignment in providing PCIT with Black families, for which they have modified treatment or suggested changes to improve cultural sensitivity. Collating suggested clinician modifications to inform a cultural adaptation of PCIT for Black families may contribute to a reduction in the attrition rate and improvement in outcomes for Black families participating in PCIT.

Factors Associated with Caregivers' Decisions to Pursue a Diagnostic Evaluation After a Positive Autism Screen in Primary Care.

We sought to understand whether a child's sex, age, race, ethnicity, caregiver education, family income, and/or number of endorsed autism signs are associated with a caregiver's decision to pursue an autism diagnostic evaluation after their child received a positive autism screen. 129 children, 17-30 months, received a positive autism screen on the Modified Checklist for Autism in Toddlers-Revised with Follow-Up, and all caregivers were offered ready access to a diagnostic evaluation by a trained professional in English or Spanish at no cost. 88 children received an evaluation and 41 did not. The likelihood of receiving an evaluation was associated with the child's race. Only 58.1% of Black children were evaluated, compared to 80% of Hispanic/Latino and 88.5% of White children. Children of Spanish-speaking caregivers showed high rates of evaluation completion (85.7%). Children who were evaluated versus were not evaluated did not significantly differ in terms of child's sex, number of autism signs endorsed by the caregiver, caregiver's education and preferred language (English versus Spanish), or household income. Even though the present study removed many common barriers to receiving a timely diagnostic evaluation, caregivers of Black children were less likely to pursue an autism diagnostic evaluation for their child. Future research is needed to understand the needs and perspectives of Black families to promote engagement in clinical care and reduce disparities in receiving a timely autism diagnosis which is important for accessing supports and services that can improve children's outcomes.

Improving Outcomes for ICU Family Members: The Role of Spiritual Care.

Having a family member hospitalized in the intensive care unit (ICU) can be a stressful experience for family members, encompassing both psychological and spiritual distress. With over 5 million ICU admissions annually in the United States, it is imperative to enhance the experiences and coping mechanisms of ICU family members. In particularly challenging situations, some family members even face psychological effects known as post-intensive care syndrome-family, which includes anxiety, depression, and posttraumatic stress. The distress may be worsened when patients and families experience poor communication or medical care, which has been shown to be more common among minoritized populations including Black and Hispanic patients and families. Family members' emotional and spiritual distress also has an effect on the medical decisions they make for the patient. While research has delved into the impact of spiritual care for ICU family members, further investigation is still needed to determine the most effective approaches for delivering such care. This narrative review will describe a conceptual model aimed at guiding future research in this endeavor. The model proposes that chaplains provide emotional, spiritual, and information support to ICU family members. This affects both their ICU experience, decision making, and outcomes for the patient and family. This process is also affected by characteristics of the family such as race, ethnicity, and economic status. This model helps identify gaps in research, including the need for randomized trials of spiritual care that identify mechanisms underlying outcomes and demonstrate impact of spiritual care, and consider race, ethnicity, and other characteristics.

The Love Jones Cohort and singlehood are family law issues

AbstractThis article reviews the changing Black family and households. The core theme is to understand the uniqueness of those single and living alone in the Black middle class—the “Love Jones Cohort”—and how their intersecting identities of race, class, gender, and singleness inform their lifestyle, shape how they manage life decisions, and their relationship to policy as well as family law and family court. This essay moves beyond the popularized and omnipresent inquiry: “Why are Black women not getting married?” or “Why are there so many single professional Black women?” This line of questioning throws the spotlight squarely on Black women's individual dating practices, while often ignoring structural factors that undergird those decision‐making processes. It implies that because of the individual actions of the Love Jones Cohort, specifically Black women, they are somehow at a deficiency if they are not married and child‐free, rendering them invisible as a family. This article discusses the legal implications of the presence of the Love Jones Cohort.

Association between Unmet Social Need and Ambulatory Quality of Care for US Children

ObjectivesChildren who experience socioeconomic adversity often have worse health; however, less is known about their quality of care. We sought to evaluate the association between parent/caregiver-reported socioeconomic adversity and quality of pediatric primary, acute, and chronic ambulatory care on a national level. MethodsThis was a retrospective cohort study of 5368 representative US children (1–17 years) in the 2021 Medical Expenditure Panel Survey. Socioeconomic adversity was defined as parent/caregiver-reported food, housing, transportation, or utility insecurity in the past 12 months. Outcomes included 10 quality measures of primary, acute, and chronic care, and experience of care measured through parent/caregiver survey. We described variation in socioeconomic adversity and used multivariable regression to examine associations with quality outcomes. ResultsOne-third of parent/caregivers reported socioeconomic adversity. Food insecurity (23.6%) was most common followed by utility (19.5%), housing (15.0%), and transportation (4.7%) insecurity. Black (53.2%) and Hispanic (46.9%) parent/caregivers experienced the highest rates of socioeconomic adversity. Children with socioeconomic adversity received lower quality of care for four quality measures, including more frequent Emergency Department visits (Odds Ratio (OR)= 1.69 [95% Confidence Interval (CI): 1.28–2.23]), less favorable asthma medication ratio (OR=0.04 [95% CI: 0.01–0.31]), and less frequent well child (OR=0.73 [95% CI: 0.59–0.90]) and dental care (OR=0.76 [95% CI: 0.63–0.94], P < .05 for all). There were no statistically significant differences in experience of care. ConclusionsSocioeconomic adversity is common among US children with disproportionate impact on Black and Hispanic families. There are significant disparities in pediatric primary, acute, and chronic care quality, based on parent/caregiver-reported socioeconomic adversity, highlighting the need for systems-level interventions.

"Actually, I don't do different": Black parents' perceptions of gender socialization of sons versus daughters.

This study expanded on research examining families' roles in youth gender development that has investigated boys' versus girls' family experiences by using a within-family design to study the gender socialization of brothers versus sisters from the same families. We drew from archival data collected in 2001-2002 from an ethnic homogeneous sample of Black American mother-father families (N = 128) who were raising at least one son and one daughter; the majority of youth were adolescents (range 2-31 years). In separate home interviews, mothers and fathers described whether and how they socialized their sons versus daughters about education, their futures, and racism and discrimination. Across these three domains, most parents reported that they did not socialize their sons and daughters differently. Nonetheless, several themes emerged that illuminated race and race-gender intersectionality in parents' socialization, both resistance and accommodation to traditional gender norms, and the role of children's personal characteristics in parents' socialization, with similar themes evident among parents who did and who did not report socializing sons and daughters differently. This study advances understanding of parents' gender socialization and has implications for family-focused interventions aimed at promoting the well-being and achievement of Black American boys and girls. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

High-Deductible Health Insurance May Exacerbate Racial And Ethnic Wealth Disparities.

This study examined the equity implications of high-deductible health plans within the context of racial and ethnic wealth disparities. Using restricted data from the Medical Expenditure Panel Survey, we evaluated the net worth (in 2011-18) and financial assets (in 2011-16) of families with private insurance and those in high-deductible health plans with and without an associated health savings account. Our results represent, to our knowledge, the first estimates of racial and ethnic wealth disparities within these populations. Results show that White households consistently held significantly more wealth than did Black and Hispanic households across income levels. In the lowest income quartile, White privately insured families had more than 350percent more in financial assets than their Black counterparts. Low-income Black and Hispanic families with high-deductible health plans but no savings accounts had median financial assets ($2,200 and $2,000, respectively) that were well below the average family coverage deductible. Study findings highlight the role of systemic racial wealth disparities, beyond that of income, to establish a unique pathway whereby high deductibles can exacerbate health care inequities.

Associations Between Infant Formula Exposure, Housing Instability and Postneonatal Mortality Among Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

To quantify infant mortality rates (IMR) using expanded racial categories, and to examine associations between infant formula exposure, housing instability and postneonatal mortality among Minnesota WIC Participants. Births in Minnesota from 2014 through 2019 (n = 404,102) and associated infant death records (n = 2034) were used to calculate neonatal and postneonatal rates using expanded racial categories. Those births that participated in the WIC program (n = 170,011) and their linked death records (n = 853) were analyzed using logistic regression to examine associations between formula exposure, housing instability, and postneonatal death. Postneonatal IMR was more than twice as prevalent among Black (African American) as East African immigrant infants (IMR = 3.9 vs 1.5). After adjustment for confounding (term status and nativity of mother (U.S. vs foreign born), infants exposed to formula by 28days were four times as likely to die in the postneonatal period as those without formula exposure (aOR = 4.0; 95% CI 3.2-4.9). WIC participants who experienced housing instability at birth were 1.7 times as likely to lose an infant in the postneonatal period (28 to 364days of age) as those in stable housing (aOR = 1.7; 95% CI 1.2, 2.4). Disaggregating Black mortality rates revealed inequities in infant mortality among Black families of varied backgrounds. Formula exposure and housing instability are modifiable risk factors associated with postneonatal mortality. Appropriate interventions to reduce barriers to breastfeeding and provide housing stability for vulnerable families could reduce disparities in postneonatal mortality.

Group-Delivered Trauma-Focused CBT Integrating Racial Socialization: A Multiple Case Study

In addition to disparities in interpersonal trauma exposures, Black youth in the U.S. experience the compounding stress of racial trauma, both of which are associated with a disproportionate mental health burden. Black youth also face barriers to engaging with trauma-specific therapies to address trauma-related mental health problems, with research suggesting that they are less likely to complete trauma-specific treatment. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based therapy for trauma-related mental health problems in youth ages 3 to 18. Metzger and colleagues (2021) proposed a set of cultural considerations for Black families to address racial stressors and enhance engagement in TF-CBT. The aim of the current multiple case study was to demonstrate the utility of group-delivered TF-CBT integrating these considerations for a single telehealth group of Black adolescents and their caregivers. We describe the intervention, patient engagement and clinical outcomes, and feedback from families regarding their experience with the group model. We also outline clinical and implementation challenges and highlight directions for future research and clinical practice.

Analyzing Community-Based Support Requests Made by Black Families Raising Autistic Children.

Black families experience additional barriers to accessing autism-related supports compared to White families. Community organizations can help mitigate the negative impact of systemic inequities and lack of support that Black caregivers of autistic family members experience. Little is known about the types of support Black families seek from these organizations. Therefore, the purpose of this study was to explore the support needs of Black families raising autistic children as evidenced by communication patterns in a community-based statewide autism organization. Our research questions were: (1) What are the autism-related support needs of Black families raising autistic children; and (2) How do familial demographics influence these support needs? We explored the support needs of Black caregivers of autistic family members by analyzing a subset of 1,460 entries (16.8% of the total communication entries) within a database of communication entries from a community-based autism organization in one southeastern state in the United States. We analyzed the frequency of support request types and the relationships between support requests and familial demographics (i.e., rurality, gender, age). We found that Black families most often requested family or individual support, school-related support, and behavioral support. Families requested support with bullying, social services, and health insurance less often. We found significant interactions between the three most requested services and the rurality, gender, and age of the autistic family member. We conclude with suggestions for autism support organizations seeking to better meet the needs of Black families.

"I Know How to Get Around Your 'No'": A Follow-Up of the FACES Psychoeducational Intervention.

Black children and their families encounter systemic disadvantages in their journey to and through an autism diagnosis. Black families often experience social and systemic barriers to service use. Providing family-centered, psychoeducational interventions can reduce barriers to service access and utilization for Black families raising autistic children. Fostering Advocacy, Communication, Empowerment, and Support (FACES) has demonstrated preliminary efficacy in strengthening outcomes among Black families, yet little is known about the long-term impact of the intervention. The purpose of this qualitative interview study was to understand the experiences of FACES graduates 16 months after the intervention. Four major themes emerged: (a) strengthened advocacy, (b) strengthened empowerment, (c) systemic barriers, and (d) home and community barriers. We provide implications for research and practice.