Lift Every Voice: Engaging Black Adolescents in Social Justice Service-Learning to Promote Mental Health and Educational Equity.

This study reports on the feasibility and acceptability of a social justice infused service-learning (S-L) program to promote Black adolescent mental health and educational equity. We convened a community advisory board to help adapt and pilot test, via open trial mixed method design, an evidence-based service-learning program for Black middle school adolescents (n = 21) attending summer camp at a faith-based setting. We describe a S-L curriculum, with a focus on the achievement gap, and training for church staff and assess staff and youth reports of feasibility, acceptability, and promise to (a) improve/engage psychological engagement targets, and (b) improve academic motivation, and social-emotional and behavioral outcomes. Mixed method findings revealed high feasibility and acceptability of the S-L intervention as indicated by consistent attendance and enthusiastic engagement by staff and youth, high satisfaction, high completion rates of planned sessions, and emergent qualitative themes from staff interviews and adolescent focus groups highlighting that service-learning (1) facilitated skills (e.g., goal-setting, social-emotional and behavioral regulation, and problem-solving), (2) shaped perspectives and inspired openness, and (3) created a space for all to feel valued and included to address the inequities of education that directly impacted them. There was preliminary evidence for efficacy in that youth report of emotional symptoms, peer problems, and staff report of general internalizing symptoms decreased following the intervention, while youth report of prosocial behaviors increased. Implications suggest that S-L programming demonstrates promise to promote mental health outcomes, raise social awareness, and inspire critical consciousness and lift the voices of Black youth by providing tools for working toward systemic changes to reduce inequities in both education and mental health.

Developing practices for hospital-based violence intervention programs to address anti-Black racism and historical trauma.

To promote health equity among Black youth exposed to community violence, it is critical that psychologists partner with other health care professionals and communities with lived experience to explicitly address anti-Black racism and historical trauma as fundamental contributors to violence-related health inequities. This article describes our community-based participatory research (CBPR) approach to develop practices for hospital-based violence intervention programs that mitigate violence-related health inequities among Black youth. Current conceptualizations of trauma-related symptoms among Black youth exposed to community violence often fail to consider the role of anti-Black racism and historical trauma in creating and maintaining traumatic stress. Our CBPR formative studies highlight the importance of and priorities to address community violence within the context of anti-Black racism and historical trauma. In describing our process and developed tools and practices, we aim to highlight the important contributions psychologists can make through interdisciplinary and community partnerships to advance health equity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"We're playing on the same team": Communication (dis)connections between trauma patients and surgical residents.

BACKGROUND: Patient-physician communication is key to better clinical outcomes and patient well-being. Communication between trauma patients and their physicians remains relatively unexplored. We aimed to identify and characterize the range of strengths and challenges in patient-physician communication in the setting of trauma care. METHODS: A qualitative, grounded theory approach was used to explore communication strengths and challenges for patients and residents. Patients previously admitted to the trauma service for violent injuries were recruited and interviewed in-person during their trauma clinic appointments. Surgical residents were recruited via email and interviewed virtually via Zoom. Anonymous, semistructured interviews were conducted until thematic saturation was reached. RESULTS: Twenty-nine interviews with patients and 14 interviews with residents were conducted. Patients reported feeling ignored and misunderstood and having inadequate communication with physicians. Residents cited lack of time, patients' lack of health literacy, differences in background, and emotional responses to trauma as barriers to effective communication with patients. Patients and residents reported an understanding of each other's stressors, similar emotional experiences regarding traumatic stress, and a desire to communicate with each other in greater depth both inside and outside of the hospital. CONCLUSION: Trauma patients and residents can feel disconnected due to the lack of time for thorough communication and differences in background; however, they understand each other's stressors and share similar emotional responses regarding trauma and a desire for increased communication, connection, and solidarity. Leveraging these shared values to guide interventions, such as a resident curriculum, may help bridge disconnects and improve their communication. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level IV.

Psychometric properties of the Community Violence-Prevention Activation Measure (CV-PAM): Evaluating provider activation toward community violence prevention.

This study reports on the conceptualization of activation, and the development and psychometrics of the Community Violence-Prevention Activation Measure (CV-PAM). The CV-PAM was adapted from the Patient Activation Measure (PAM; Hibbard et al., 2004, Health Serv Res, 39, 1005-1026; Hibbard et al., 2005, Health Serv Res, 40, 1918-1930) for use among a workforce servicing youth exposed to community violence. Activation toward community violence prevention is defined as a process in which community members are activated to prevent violence, believe they have important roles to play in violence prevention and supporting the well-being of community members. Activated community members have a good understanding of the factors that contribute to violence and they apply skills and strategies that are consistent with prevention efforts. Six hundred and ninety-four youth providers completed the 18-item CV-PAM to describe their level of activation toward community violence. Exploratory and confirmatory factor analyses were performed and demonstrated that a three factor versus a four factor structure of activation (modeled after PAM) held together. The three factors included (a) belief that an active role is important to address community violence; (b) having the confidence and knowledge to take action around community violence prevention; (c) taking action: frequency of participation and responsiveness to community needs. The proposed fourth factor, staying the course under stress, did not have any qualifying loadings, and thus, could not be interpreted. CV-PAM performed well in tests of reliability and validity. The CV-PAM appears to be a precise, valid, reliable, and useful measure. Implications suggest that using this tool is potentially the first step toward understanding activation among engaged providers and a stepping stone toward increased involvement in community violence prevention through implementation and dissemination efforts.

Building Resilience After School for Early Adolescents in Urban Poverty: Open Trial of Leaders @ Play.

Leaders @ Play is a park after-school program for urban middle school youth designed to leverage recreational activities for social emotional learning. Mental health and park staff co-facilitated sports and games to teach and practice problem solving, emotion regulation, and effective communication. Additional practice occurred during multi-family groups and summer internships as junior camp counselors. We examined feasibility and promise via an open trial (n = 3 parks, 46 youth, 100 % African American, 100 % low-income, 59 % female, M = 13.09 years old). Improvements in social skills and reductions in problem behaviors lend support to after school programs as a space for mental health promotion.

Common elements of adolescent prevention programs: minimizing burden while maximizing reach.

A growing number of evidence-based youth prevention programs are available, but challenges related to dissemination and implementation limit their reach and impact. The current review identifies common elements across evidence-based prevention programs focused on the promotion of health-related outcomes in adolescents. We reviewed and coded descriptions of the programs for common practice and instructional elements. Problem-solving emerged as the most common practice element, followed by communication skills, and insight building. Psychoeducation, modeling, and role play emerged as the most common instructional elements. In light of significant comorbidity in poor outcomes for youth, and corresponding overlap in their underlying skills deficits, we propose that synthesizing the prevention literature using a common elements approach has the potential to yield novel information and inform prevention programming to minimize burden and maximize reach and impact for youth.

The influence of nondisclosure on the mental health of urban African-American adolescents exposed to community violence.

African-American youth residing in urban poverty have been shown to be at increased risk for exposure to violence and internalizing symptoms, but there has been little investigation of moderating processes that might attenuate or exacerbate this association. The current study examined nondisclosure as a possible moderator of the association between community violence and internalizing symptoms with a sample of 152 low-income urban African-American early adolescents using hierarchical regression analyses. Results revealed that nondisclosure for relationship reasons (e.g., adults could not be trusted to provide needed support) moderated the association between exposure to community violence and internalizing symptoms. Unexpectedly, however, results of simple effects analyses revealed a stronger association between exposure to violence and internalizing symptoms for youth who disclosed more to adults. Although unexpected, this pattern builds upon prior research indicating that adult-child relationships are compromised within the context of urban poverty and that protective factors may lose their power under conditions of extreme stress.