Racial-Ethnic Socialization Intervention for Family Mental Health

(OTAAT Trial)

Overseen By Gabriela Livas Stein, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Greensboro

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

312 Participants Needed

Trial Summary

What is the purpose of this trial?

This study is a randomized effectiveness trial that tests the online delivery of a video-based intervention (One Talk at a Time (OTAAT)) relative to a control group over a one-year span. Hypotheses include: 1.) The OTAAT intervention will increase parental motivation to engage in racial-ethnic socialization (RES) conversations, their skills and confidence in having these conversations, and the frequency and quality of these conservations; 2.) The OTAAT intervention will increase youth reports of their coping with discrimination, perceived efficacy in coping with discrimination in the future, ethnic-racial identity, and youth mental and academic outcomes; 3.) Greater parental discrimination and youth discrimination will moderate links between OTAAT intervention and parental ethnic-racial motivation + competency as well as youth ethnic-racial identity, coping, and psychosocial outcomes.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment One Talk at a Time for family mental health?

Research suggests that culturally adapted family-based interventions can improve engagement in mental health services for racial-ethnic minority families, which is a key component of the One Talk at a Time treatment. Studies indicate that addressing cultural context and involving family support can enhance treatment participation and outcomes for minority youth. ^{1 2 3 4 5}

How is the treatment 'One Talk at a Time: Race' different from other treatments for family mental health?

The 'One Talk at a Time: Race' treatment is unique because it focuses on racial-ethnic socialization, which involves open communication about racial experiences to improve family mental health. This approach is culturally tailored to address the specific needs of ethnic minority families, unlike standard treatments that may not consider these cultural factors. ^{1 3 5 6 7}

Research Team

Gabriela Livas Stein, PhD

Principal Investigator

University of Texas at Austin

Stephanie Coard, PhD

Principal Investigator

University of North Carolina, Greensboro

Lisa Kiang, PhD

Principal Investigator

Wake Forest University

Eligibility Criteria

This trial is for parents from the same pan-ethnic group with a child aged 11 to 13. It's specifically aimed at families where the parent identifies as East Asian, African American, or Latinx (Central American).

Inclusion Criteria

I am a parent of a child aged 11 to 13.

Both parents are from the same pan-ethnic group

Parental race/ethnicity must be either of East Asian, African American, or Latinx (Central American) background

Exclusion Criteria

N/A

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the One Talk at a Time (OTAAT) intervention or control materials. The intervention consists of 11 videos and takes approximately 1.5-2 hours to complete online.

1 month

Online delivery

Follow-up

Participants are monitored at 3-month, 6-month, and 12-month intervals with surveys and observational tasks to assess various psychosocial outcomes.

12 months

4 follow-up assessments (online and optional in-person)

Maintenance

Participants receive 6 additional OTAAT contacts via text messages/newsletters spread out across the year to reinforce skills and set times for RES conversations.

10 months

Treatment Details

Interventions

• One Talk at a Time: General
• One Talk at a Time: Race

Trial Overview The study tests an online video-based intervention called 'One Talk at a Time' against a control group over one year. It aims to improve parental engagement in racial-ethnic socialization and enhance youth coping with discrimination and their mental and academic outcomes.

Participant Groups

Group I: OTAAT Experimental Treatment 1 Intervention

This group will receive the One Talk at a Time curriculum.

Group II: Parent-Child Communication Active Control 1 Intervention

This group will receive a curriculum focused on tips and strategies for navigating difficult topics with one's children such as current events and dating.

One Talk at a Time: Race is already approved in United States for the following indications:

Approved in United States as One Talk at a Time for:

• Racial-ethnic socialization intervention for diverse families

Who Is Running the Clinical Trial?

University of North Carolina, Greensboro

Lead Sponsor

Trials

33

Recruited

16,700+

Findings from Research

Current measures of engagement in mental health services do not adequately consider culturally specific factors that affect how ethnic minority and immigrant families interact with these services, highlighting a significant gap in existing tools.

The review of 119 instruments reveals that while there are various tools to measure engagement, they often fall short in addressing the unique needs of these families, suggesting a need for new methodologies and practical applications to improve service delivery and reduce disparities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families. Yasui, M., Pottick, KJ., Chen, Y.[2023]

Suicide rates among youth of color are highest before age 30, and existing prevention strategies often overlook the role of structural racism in creating disparities in mental health service access and effectiveness.

The authors propose a new framework that highlights how structural racism affects suicide prevention across mental health services, schools, and crisis care, and they recommend comprehensive interventions to address these systemic issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems. Alvarez, K., Polanco-Roman, L., Samuel Breslow, A., et al.[2022]

The article highlights significant health disparities in mental health care for African American youth, emphasizing the need for innovative interventions to improve their access to psychiatric services.

An evidence-based intervention has been developed to enhance family engagement in mental health treatment for depressed African American adolescents, aiming to address their unique cultural needs and improve participation in psychiatric care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family first: the development of an evidence-based family intervention for increasing participation in psychiatric clinical care and research in depressed African American adolescents. Breland-Noble, AM., Bell, C., Nicolas, G.[2022]

The study aims to develop and evaluate a culturally informed Family Motivational Engagement Strategy (FAMES) to improve family engagement in coordinated specialty care (CSC) programs for first episode psychosis, particularly among racial and ethnic minority families.

The research will involve a multi-phase approach, including a survey of approximately 200 family members to identify barriers to engagement, followed by a 3-month trial and a 16-month non-randomized trial with 50 family members to assess the acceptability and feasibility of the FAMES toolkit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol. Oluwoye, O., Dyck, D., McPherson, SM., et al.[2021]

A systematic review of 1264 studies identified 10 that effectively targeted mental health treatment engagement among underserved racial-ethnic minority young adults, highlighting a significant gap in research for this population.

Interventions that were family-based or culturally adapted showed promising results, suggesting that incorporating family support and cultural context is crucial for improving engagement in mental health services for young adults aged 13 to 27.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Health Service Engagement Among Underserved Minority Adolescents and Young Adults: a Systematic Review. Moore, KL.[2021]

The EMBRace racial socialization intervention, conducted over five weeks, showed promising results in enhancing coping strategies for Black American families, leading to reduced psychosocial problems in adolescents despite ongoing racial stress.

This case study suggests that racial socialization can be a beneficial therapeutic approach, indicating the need for further research with larger samples to explore its effectiveness and implications for policy and program development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addressing the Mental Health Needs of Black American Youth and Families: A Case Study from the EMBRace Intervention. Anderson, RE., Jones, SCT., Navarro, CC., et al.[2022]

The culturally adapted Youth Mental Health First Aid (YMHFA) training significantly improved mental health literacy and confidence in using mental health first aid skills among 31 Asian immigrant parents and 24 Asian American youth workers.

Participants reported positive experiences with the training and suggested further cultural adaptations, indicating that this tailored approach may effectively engage Asian Americans in seeking mental health services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culturally adapting youth mental health first aid training for Asian Americans. Wang, C., Liu, JL., Marsico, KF., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Family first: the development of an evidence-based family intervention for increasing participation in psychiatric clinical care and research in depressed African American adolescents. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Mental Health Service Engagement Among Underserved Minority Adolescents and Young Adults: a Systematic Review. [2021]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Addressing the Mental Health Needs of Black American Youth and Families: A Case Study from the EMBRace Intervention. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Culturally adapting youth mental health first aid training for Asian Americans. [2022]