About this poster

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Panel information
Panel 6. Risk, Intervention, Prevention, and Action

Abstract

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Background: In the U.S., racial and ethnic minoritized children face an increased risk of trauma due to poverty, neighborhood violence, institutionalized racism, and family stress (Alegria et al., 2010; Spencer & Swanson, 2013; Yoshikawa et al., 2012), which in turn affects their overall mental health, academic performance, and coping skills (Bethell et al., 2014). Minoritized youth experience unique and significantly higher levels of unmet mental health needs. African Americans, Latinxs, and Asian Americans have less access to mental health services compared to their white counterparts (Cook et al., 2017). Therefore, racialized and minoritized children and adolescents are less likely to receive mental health treatment (Costello et al., 2014).

However, not all children and adolescents who undergo trauma or adversities experience mental health disorders or impaired functioning. Over the past few decades, there has arisen a growing body of literature aimed at understanding the process and mechanism of resilience. Numerous prevention programs seek to cultivate protective and promotive factors.

Schools often function as ideal sites for prevention programs to foster racially minoritized children’s resilience and mental wellness. However, many school-based prevention programs are generally designed as universal, "one-size-fits-all" interventions, which could potentially miss the opportunity to better address mental health disparities affecting children of color. This study aims to provide synthesized evidence on culturally adapted or culturally grounded prevention and promotion interventions in school settings to address racially minorized children’s needs in the US.

Method: Adhering to PRISMA guidelines, literature searches were conducted using EBSCOhost, ProQuest, and Web of Science, complemented by checking reference lists and grey literature with specific keywords. Studies qualified if they: 1) employed experimental or quasi-experimental designs with control or comparison groups; 2) targeted children aged 18 and under in the U.S.; 3) were implemented in school settings; 4) focused on fostering resilience, such as social-emotional skills, or mitigating symptoms of internalizing problems; and 5) contained a culturally adapted or relevant component in the intervention. Data from these studies were extracted, tabulated, analyzed, and synthesized for quality assessment and meta-analysis, with overall and subgroup effect sizes estimated using R.

Findings: The research team independently screened 2,147 records from databases and grey literature, resulting in 12 studies that involved 3,053 racially minoritized children in the U.S. The majority of the school-based interventions targeted African American children (N=8), utilized randomized controlled trials (N=7), employed ANCOVA (N=6), and addressed social and emotional skills (N=9) as well as internalizing problems, including depression, anxiety, stress, and suicidal ideation (N=5). Using a 10-item quality assessment, the included studies had a moderate sound research design, with a mean score of 7.08 (SD = 1.38) out of 10, ranging from 5 to 9. In terms of the pooled effect sizes of the included culturally sensitive interventions targeting racially minoritized children, the random effect models revealed a small to medium effect in promoting students’ social and emotional competencies (SEC) (ES=0.414; 95% CI: 0.280, 0.547) and a large effect in reducing and preventing internalizing symptoms, including anxiety, stress, and depression (ES=1.061; 95% CI: 0.855, 1.266).

Conclusions & Implications: This systematic review and meta-analysis posits encouraging evidence that culturally sensitive school-based programs can promote resilience and reduce internalizing problems of racially minoritized children in the U.S. In order to corroborate these results, future studies should prioritize enhancing methodological quality in addition to increasing efforts to develop and implement culturally attuned prevention and promotion programs. This study’s findings recommend increasing the sample size, including a wider range of racially minoritized groups—in particular, Asian Americans and indigenous peoples—and setting clear standards for cultural adaptation of interventions in school settings.

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