Date of Award

2025

Document Type

Open Access Dissertation

Department

Psychology

First Advisor

Dawn K. Wilson

Abstract

Black adolescents have higher rates of physical inactivity, lower quality dietary intake, and fewer family meals compared to their White peers. These health inequities place Black adolescents at greater risk for overweight and obesity, as well as long-term health consequences, including chronic disease and early mortality. However, few health promotion programs have been successful in improving health behaviors among Black adolescents and families. Elevated rates of chronic stress, namely racial stress, among Black families may be a prominent obstacle for engagement in and effectiveness of health promotion initiatives. Limited family-based health promotion programs with Black families have incorporated cultural and family resilience frameworks to address stress, namely racial stressors. Of the limited existing resilience trials, prior trials have only included a limited set of core resilience resources, often overlooking racial identity and cultural assets, and have been limited in methodological rigor. Moreover, to the best of our knowledge, none have targeted health promotion behaviors as outcomes except for our research team’s recent LEADS feasibility trial. Preliminary work from the LEADS feasibility trial shows initial feasibility and acceptability of cultural and family resilience curriculum with overweight/obese Black adolescents and families; however, feedback from LEADS families on cultural curriculum was limited to a small sample size of 10 dyads and only targeted physical activity outcomes. Thus, the current study included the integration and evaluation of novel cultural and family resilience intervention curriculum with all core resilience resources, gathered real-time feedback from a larger sample of dyads, and examined health behavior changes from a wider range of outcomes (physical activity, dietary intake, family meals). The proposed study aimed to fill the gaps in prior research and expand on the LEADS feasibility trial with the following aims to 1) assess parent and adolescent feasibility and acceptability of intervention curriculum, family curriculum engagement, and family interactions, and to 2) assess changes in adolescent physical activity, dietary intake, and family mealtime from Timepoint 1 to Timepoint 2. Data were collected from Black adolescents and their parent/caregiver (n = 31 dyads; Madolescent age = 13.4 years; 58.1% female; MBMI% = 96.3%). Process evaluation findings demonstrated high feasibility and acceptability of resilience intervention curriculum, moderate family engagement with curriculum, and strong parental support and positive family interactions and communication. In line with hypotheses, findings also demonstrated trending improvements in adolescent-reported family mealtime frequency and fruit and vegetable intake and trending reductions in snack intake and sweetened beverage intake among the intervention group from Timepoint 1 to Timepoint 2. Contrary to hypotheses, adolescent-reported family mealtime quality showed slight trending declines among both the intervention and control group. Follow-up qualitative feedback highlighted strengths of the program (e.g., approached challenging conversations about race, increased family bonding, increased stress coping tools) and recommendations for improvement for future resilience trials (e.g., culturally salient coping, discuss more health inequities, integrate financial literacy). These findings provided notable insights that informed the LEADS R01 trial and provide preliminary support for future family-based resilience health promotion programs conducted with Black families.

Rights

© 2025, Mary Quattlebaum

Download

Share

COinS