Using a Randomized Clinical Trial to Test the Efficacy of a Culturally Responsive Mobile Health Application in African Americans

Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this population. One way to address this need is to develop and test if culturally responsive mobile health (mhealth) applications are efficacious in reducing stress-related outcomes in this population. With this goal in mind, we employed a repeated-measures randomized control trial (RCT) across a 12-week intervention period to evaluate if participants in the intervention group outperformed a wait-list control group in reductions in stress, depressive symptoms, anxiety, emotional regulation difficulties as well as in increases in self-compassion, resilience, and mindfulness attitudes and behaviors. Our sample included 170 Black/African American participants who were randomly assigned to either the intervention condition (n = 84) or the wait-list control group (n = 86). Participants in the intervention condition reported more self-compassion, used more mindfulness, and had greater self-efficacy using mindfulness; yet, no other differences were evident. Participants expressed high levels of satisfaction with the app and gave it a positive rating for its relevance to their lives. These findings support the efficacy of a culturally responsive mindfulness mHealth app to enhance self-compassion and increase the use of health-promoting behaviors, like mindfulness, among African Americans. Implications for future research are discussed.

Need for closure and ethnic identification: The varied roles of cultural intelligence in a multiethnic group society

Multiethnic group countries are distinctive in that ethnic identification/loyalty and national identification/loyalty sometimes contend. In addition, the different ethnic groups that make up these countries though interdependent compete for relevance. Such a mode of social relationship creates uncertainty and heightens the consciousness of group survival. These characteristics make African countries rich sites for the investigation of intergroup relations. Given this context, the need for closure and cultural intelligence were examined in relation to ethnic identification. Data were collected via the use of questionnaires from a sample of undergraduate students drawn from different ethnic groups. Findings show that the need for closure and cultural intelligence are directly related to ethnic identification. Also, cultural intelligence was a significant moderator of the relationship between need for closure and ethnic identification. Findings suggest that cultural intelligence may encourage an open-mindedness which could help promote successful social interactions in multigroup countries. In addition, the results of this study support theoretical and empirical positions that have advanced group interdependence as a potent tool for intergroup cooperation.

Race Differences in Resilience Among Older Adults with Chronic Low Back Pain

Introduction

Racial minorities are disproportionally affected by pain. Compared to non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs) report higher pain intensity, greater pain-related disability, and higher levels of mood disturbance. While risk factors contribute to these disparities, little is known regarding how sources of resilience influence these differences, despite the growing body of research supporting the protective role of resilience in pain and disability among older adults with chronic pain. The current study examined the association between psychological resilience and pain, and the moderating role of race across these relationships in older adults with chronic low back pain (cLBP).

Methods

This is a secondary analysis of the Adaptability and Resilience in Aging Adults (ARIAA). Participants completed measures of resilience (ie, gratitude, trait resilience, emotional support), as well as a performance-based measure assessing lower-extremity function and movement-evoked pain.

Results

There were 45 participants that identified as non-Hispanic White (NHW) and 15 participants that identified as non-Hispanic Black (NHB). Race was a significant correlate of pain outcomes with NHBs reporting greater movement-evoked pain (r = 0.27) than NHWs. After controlling for relevant sociodemographic characteristics, measures of movement-evoked pain were similar across both racial groups, F (1, 48) = 0.31, p = 0.57. Moderation analyses revealed that higher levels of gratitude (b = −1.23, p = 0.02) and trait resilience (b = −10.99, p = 0.02) were protective against movement-evoked pain in NHWs. In contrast, higher levels of gratitude were associated with lower functional performance in NHBs (b = −0.13, p =0.02).

Discussion

These findings highlight racial differences in the relationship between resilience and pain-related outcomes among older adults with cLBP. Future studies should examine the potential benefits of targeted interventions that improve resilience and ameliorate pain disparities among racial minorities.

Meaning in Life Predicts Decreased Depressive Symptoms and Increased Positive Affect over Time but Does Not Buffer Stress Effects in a National Sample of African-Americans

Few studies have specifically focused on meaning in life in African Americans and many important questions remain, including whether effects of meaning in life are direct or moderated by levels of stress. In a national sample of 909 African Americans, we tested meaning in life as a prospective predictor of changes in depressive symptoms and positive affect over a 2.5-year period. Controlling for demographics and hassles, meaning in life predicted decreased depressive symptoms and increased positive affect across the span of 2.5 years. Moderation effects were not found for hassles, age, or income. Gender moderated the effect of meaning on positive affect such that effects were stronger for women than for men. These results suggest that, for African Americans, meaning in life appears to robustly protect against future depressive symptoms and promote positive affect over time unaffected by amount of stress experienced or most demographic factors.

A mixed-methods exploration of faith, spirituality, and health program interest among older African Americans with HIV

BACKGROUND

Persons living with HIV (PLWH) are living into old age with more complex care needs that non-PLWH. Promoting quality of life should include advance care planning (ACP) education, particularly among African Americans. We explored faith/spirituality-related correlates of interest in a future quality of life program among African American PLWH.

METHODS

Data were from the AFFIRM study. Participants were recruited from an HIV clinic and completed surveys, interviews, and focus groups. Quantitative analyses included Logistic regression. Qualitative data were coded using grounded theory.

RESULTS

Nearly half of participants had less than a high school education (47.9%), and roughly 90% had heard of at least one ACP-related topic (86.6%; N = 315). Qualitative themes related to quality of life and faith/spirituality were: (1) Coping with life challenges; (2) Motivation to improve health for loved ones; and (3) Support programs for people with HIV (N = 39). Satisfaction with religion/spirituality was associated with greater interest in a future program (p < .05); discussing ACP before getting sick was associated with less interest (p < .05).

CONCLUSIONS/PRACTICE IMPLICATIONS

Prioritizing skill-building and grounding in spirituality with input from faith leaders can reduce ACP inequities and improve health outcomes among African Americans.

Specific Features of Ethnic Identity in the Regions with Varying Degrees of Ethnic Diversity

Ethnic diversity describes the plurality of ethnicities within a group of people coexisting in one territory. The permanent presence of other cultures’ representatives can trigger a sense of jeopardy; a feeling that the prevailing way of life, its norms, and its values are challenged by strangers, which results in hostility to ethnic minorities living in the same territory. In this context, the study aimed at investigating specific features of the individual’s ethnic identity determined by the degree of the ethnic diversity of their living environment is of relevance. In order to define regions for the study, the comparative analysis of the ethnic diversity of Russian regions was conducted. Two regions for the study were defined: the Sverdlovsk region as a territory with average ethnic diversity and the Republic of Bashkortostan as a highly diverse region in terms of ethnicity. The respondents from less ethno-diverse areas exhibit global self-identification, the awareness of being a part of the world, and territorial identity. Differences in the degree of sustainability and the intensity of ethnic self-identification of the subjects from regions with varying degrees of ethnic diversity were revealed. Significant distinctions in the meaning of ethnicity for the compared groups of the respondents were found.

Prospective associations between trauma, placement disruption, and ethnic-racial identity among newly emancipated foster youth

INTRODUCTION

Ethnic-racial identity (ERI) is an important developmental process for ethnic-racial minority youth. However, little is known about how adverse life experiences may be related to ERI development. Thus, the current study evaluated prospective associations of emancipated foster youth's histories of childhood maltreatment and foster placement disruption with ERI centrality and ERI private regard, as well as the adaptive implications of ERI.

METHOD

Participants were 144 emancipated foster youth (69.4% female) from ethnic-racial minority backgrounds (27.8% Black, 32.6% Latinx, 39.6% multiracial) who participated in a longitudinal study of youth's adaptation to aging out of the US child welfare system. Youth reported on their childhood maltreatment severity and child welfare placement history at wave 1 (M_{age_w1} = 19.62, SD = 1.11), and on their ERI centrality, ERI private regard, and socioemotional adjustment (i.e., social support, self-esteem, anxiety and depressive symptoms, and life satisfaction) five years later (M_{age_w2} = 24.15).

RESULTS

Path analyses revealed that childhood maltreatment severity and placement disruption were associated with lower ERI private regard, but not ERI centrality. Moreover, private regard was associated with better socioemotional adjustment (i.e., higher levels of self-esteem and social support), whereas centrality was related to poorer adjustment (i.e., lower levels of self-esteem and life satisfaction, and higher rates of anxiety and depressive symptoms), and these relations varied by ethnicity-race.

CONCLUSIONS

The current findings suggest that efforts to promote positive feelings toward one's ethnic-racial group membership can support ethnic-racial minority foster youth's capacity to negotiate developmental challenges in and beyond the child welfare system.

Coping and Culture: The Protective Effects of Shift-&-Persist and Ethnic-Racial Identity on Depressive Symptoms in Latinx Youth

Shift-&-persist is a coping strategy that has been shown to lead to positive health outcomes in low-SES youth but has not yet been examined with respect to psychological health. This study tests whether the shift-&-persist coping strategy works in tandem with ethnic-racial identity to protect against depressive symptoms in the face of two uncontrollable stressors: economic hardship and peer discrimination. In a sample of 175 Latinx youth (51.4% female; M_age = 12.9), shift-&-persist buffered the positive relation between economic hardship and depressive symptoms. In terms of peer discrimination, among youth who reported little use of shift and persist, discrimination was related to higher depressive symptoms, whereas youth who reported higher amounts of shift and persist (at and above the mean) were protected and did not evidence this association. However, among youth with high ethnic-racial identity, shift-&-persist failed to protect against the deleterious association between peer discrimination and depressive symptoms. These findings suggest that shift-&-persist is protective for Latinx youth, although the context in which it is protective changes based on the racialized/non-racialized nature of the stressor.

Cultural Identity, Africultural Coping Strategies, and Depression as Predictors of Suicidal Ideations and Attempts Among African American Female College Students

Suicide prevention is a growing health concern in America for many minority groups. Although experts agree suicide is associated with cultural practices and beliefs, there is limited evidence on how African American women cultural values and practices influence their low rates of suicide. This study explores cultural identity, Africultural coping strategies, and depression as predictors of suicidal ideations and attempts among African American female college students. It was hypothesized that suicidal ideations and attempts are negatively related to cultural identity and Africultural coping styles, but positively related to depression. One hundred and thirty-seven African American female students were administered a battery of measures assessing cultural identity, coping strategies, and suicidal ideations and attempts. Results revealed that Africultural coping strategies and depression emerged as significant predictors of suicidal ideation and attempts. Results are discussed in terms of African American culture as a buffer to possible suicidal behavior in African American women.

The impact of indigenous cultural identity and cultural engagement on violent offending

BACKGROUND

Possessing a strong cultural identity has been shown to protect against mental health symptoms and buffer distress prompted by discrimination. However, no research to date has explored the protective influences of cultural identity and cultural engagement on violent offending. This paper investigates the relationships between cultural identity/engagement and violent recidivism for a cohort of Australian Indigenous people in custody.

METHODS

A total of 122 adults from 11 prisons in the state of Victoria completed a semi-structured interview comprising cultural identification and cultural engagement material in custody. All official police charges for violent offences were obtained for participants who were released from custody into the community over a period of 2 years.

RESULTS

No meaningful relationship between cultural identity and violent recidivism was identified. However a significant association between cultural engagement and violent recidivism was obtained. Further analyses demonstrated that this relationship was significant only for participants with a strong Indigenous cultural identity. Participants with higher levels of cultural engagement took longer to violently re-offend although this association did not reach significance.

CONCLUSIONS

For Australian Indigenous people in custody, 'cultural engagement' was significantly associated with non-recidivism. The observed protective impact of cultural engagement is a novel finding in a correctional context. Whereas identity alone did not buffer recidivism directly, it may have had an indirect influence given its relationship with cultural engagement. The findings of the study emphasize the importance of culture for Indigenous people in custody and a greater need for correctional institutions to accommodate Indigenous cultural considerations.