The Black Parenting Strengths and Strategies Program: A Randomized Pilot Study

1. The Black Parenting Strengths and Strategies Program: A Randomized Pilot Study Stephanie I. Coard, Ph.D.Associate Professor Human Development and Family Studies, UNCG Presented at the Developmental Psychology Brown Bag University of North Carolina-Greensboro October 19, 2007

2. Acknowledgements MENTORS: Linda Burton, Ph.D., Penn State University Robert T. Carter, Ph.D, Teachers College, Columbia University Jessica Henderson Daniel, Ph.D., Harvard University Michelle Fine, Ph.D, City University of New York Vonnie McLoyd, Ph.D., UNC-Chapel Hill Velma McBride Murry, Ph.D., University of Georgia Robert Sellers, Ph.D., University of Michigan Elwood Robinson, Ph.D., North Carolina Central University Margaret Beale Spencer, Ph.D., University of Pennsylvania Howard Stevenson, Ph.D., University of Pennsylvania Donna Marie Winn, Ph.D., Duke University

3. Mission The prevention and treatment of child mental health problems and the promotion of emotional and behavioral health –with particular emphasis on Black/African American children, adolescents and their families. What does that mean?…

4. Remaining at the forefront of research in prevention and comprehensive treatments for/with African American youth and facilitating awareness of the importance of examining and understanding the role of race, ethnicity and culture in the conduct of research. • Elucidating roles of race/ethnicity in development • These factors contribute to the complexities of psychological processes, and are of vital importance to the understanding of culturally diverse populations.

5. 2. Integrate existing and new knowledge on culture, ethnicity and race with intervention efforts aimed at preventing and treating child mental health problems and fostering competence and well being. • As evidenced-based interventions are applied to children within diverse families, schools and communities, the understanding of culture and how specific culture-related factors influence implementation, acceptance and outcome become paramount.

6. Outline of Presentation Research Overview • Rationale and limitations Racial Socialization Overview • Definition and Importance Intervention Development Phases • Cultural adaptation process • Intervention components Pilot Findings Conclusions and Future Directions

7. K01 Award:Cultural Strategies for Preventing Conduct Problems • Pursue research on translation, implementation and testing of clinically efficacious interventions into community settings; and in culturally adapting and testing those interventions to ensure successful dissemination within urban and inner-city communities. • A primary focus of this research has been the development and testing of culturally-relevant strategies to assist African American parents in preventing and managing common behavioral problems in children. Funded by National Institute of Mental HealthK01 MH-01881-012000-2005

8. Limitations of Parent Training Interventions Increase in contextually focused evidenced-based preventive intervention, BUT… • Focus on “surface” modifications rather than the consideration of “deeper” structural cultural adaptations. • Consideration to critical values and traditions of a particular ethnic group, the unique historical, present, and future conditions of the group have largely been ignored. • Do not consider the unique parental challenges that African American families experience and unique parenting practices that are culturally, ethnically, racially-based, valued and influenced by the societal realities that exist (e.g., racism, prejudice, discrimination).

9. Racial Socialization Defined • The process by which messages are transmitted inter- and intra-generationally regarding the significance and meaning of race and ethnicity. • Involves teaching children values and norms associated with race/ethnicity, and problem-solving skills that enable children to be flexible in their approach to race-related situations, without losing a core sense of self. Coard, S. & Sellers, R. African American families as a context for racial socialization. (2005) In V. McLoyd, N. Hill and K. Dodge, (eds.) Emerging Issues In African-American Family Life: Context, Adaptation, and Policy. New York: Guildford Press. Stevenson, H., Winn, D.M., Walker-Barnes, C. & Coard, S.Style Matters: Towards a culturally relevant framework for interventions with African American families (2005) In V. McLoyd, N. Hill and K. Dodge, (eds.) Emerging Issues In African-American Family Life: Context, Adaptation, and Policy. New York: Guildford Press.

10. Complexities of Racial Socialization • Synergistic and dynamic • Bi-directional process • Deliberate and unintended • Transmission and reception • Moderated by family and ecological characteristics

11. Racial Socialization and Child Outcomes: Empirical Findings Racial Competence Academic Achievement Self-Efficacy Self-Esteem Behavioral Competence Delinquency Drug Abuse

12. Why is Racial Socialization Important? • It influences a children’s beliefs about the way the world works. • It informs children’s beliefs and attitudes regarding ‘the self’. • It helps shape children’s repertoire of strategies and skills for coping with and navigating racism. • It impacts the nature of the child’s’ inter- and intra-racial relationships and interactions.

13. Race and/or Ethnicity Black and/or African American Biracial Multiracial Race of parent and/or race of child Race of grandparent and/or race of parent and/or child And the answer is… Barbershops/hairdressers Nail salons Resource/drop in centers Schools (drop off/dismissal) Housing projects Playgrounds/Parks Block Parties/Festivals Restaurants/Take-outs Community Centers YMCA Churches/mosques DMV Street vendors Caretakers/nannies Who am I Targeting?A quest to define Blackness

14. Intervention Development Phases 1. Qualitative Study: Further elaborate the key aspects of racial socialization through qualitative methods and review of historical, sociological, and psychological literatures. 2. Program Adaptation: Develop an intervention for African American parents of 5 – 7 year old socio-economically disadvantaged children that encourages parents use of racial socialization practices. 3. Assessment Battery: Develop an assessment battery that is sensitive to changes in racial socialization practices and related constructs. 4. Open Pilot : Pilot the racial socialization intervention as an adjunct to a standard parent training intervention. 5. Randomized Controlled Pilot: Test the enhanced parent training intervention in a randomized controlled trial (waitlist control).

15. Model of Racial Socialization Processes (Coard, 2003) Frequency of Message Frequently Used Routine aspect of parenting Moderated by family characteristics Content of Messages Racial Preparation (83%) Racial Pride (93%) Racial Equality (86%) Racial Achievement (67%) Racial Socialization Mode/Delivery of Messages Active Responsive Passive Coard, S. & Wallace, S., & Stevenson, H. & Miller Brotman, L. (2004). Towards culturally competent preventive interventions: The consideration of racial socialization in parent training with African American families. Journal of Child and Family Studies, 13 (3), 277-293.

16. Content: Black child development Using proactive racial socialization strategies Talking to your child about race Knowledge of African American history Encouraging culturally affirming attitudes and behaviors Coping with race-related conflicts Race-related advocacy in school settings *informed by qualitative findings and existing literature Delivery Strategies: Use of AA language expression, common language Physical expression Emphasize AA values about collective responsibility, cooperation and interdependence. Use of African proverbs, sayings/affirmations, poems, quotes, symbols, pledges African American perspective use of (“we”) Prayer Role-playing Storytelling/testimonies Extended family participation Humor Setting/Motif- representative of population (e.g., books, magazines, pictures) Other Culturally-Specific Considerations*

17. Program Overview: A culturally- and strengths-based parenting program for the prevention of conduct problems of young children grades K-2. Weekly session (12 weeks) Two hour sessions Meals and childcare/tutoring Ticket system Attendance (on time) Homework completion Binder Program goals: STRENGTHEN parenting skills IMPROVE parental involvement EMPOWER parents to advocate and access GUIDE parents in preparing African-American children for success So we can…. INCREASE positive behaviors in children DEVELOP self-image and self-esteem BUILD their confidence in school PROMOTE positive racial discussions ENHANCE problem-solving skills Culturally Enhanced Version:Black Parenting Strengths and Strategies (BPSS)

18. Parenting the Strong-Willed Child (Long & Forehand, 2002) • Evidence-based behavioral parent training program, recognized for its general effectiveness. • Designed to improve the parent-child relationship and increase desirable child behaviors. • Teaches skills that assist parents in dealing with and preventing noncompliance and other problematic behavior. • Skills: Attending, Rewards, Ignoring, Effective directions, Time Out

19. BPSS Parent Group Sessions: 1- 6 1Welcome and Introduction Parenting in Context: Yourselves as Black Parents Self –Reflection 2 Black Discipline: Stickin’ To, Watchin’ Over and Gettin’ With* Affection, Protection and Correction 3Young Children and Racial-Ethnic Matters Racial/Ethnic Development and Competence Racial Socialization: Talking about Race 4Understanding Child Behavior and Identifying BehaviorProblems Attending 5 Creating a Positive Homeplace** and Homespace*** Spirituality and Family Traditions Rewards 6Improving Communication Skills Ignoring *Based on Stevenson, Davis & Abdul-Kabir (2001) **Term conceived by L. Burton *** Term conceived by J.V. Ward

20. BPSS Parent Group Sessions: 7 - 12 7 Building Positive Self-Esteem and Self-Image Effective Directions 8Developing More Patience and Respect Time-Out 9 Black Children and the School Experience Racial Achievement 10 Teaching Children to Problem Solve Chit chats and Race–Related Problem Solving 11Integrating Parenting/Behavior Change Skills Addressing Specific Behavior Problems 12Advocating for Your Child Addressing specific race/ethnic matters (at home and in the community) 13 Graduation Ceremony

21. Child Domains and Measures • Child Behavior Problems • Child Social Competence • Child Racial Competence • Attitudes • Coping • Racial Preference • Behavioral Assessment System for Children (BASC- P/T) • Behavioral Assessment System for Children (BASC- P/T) • Social Skills Rating Scale(SSRS-P/T) • Preschool Racial Attitude Measure(PRAM) • Racial Stories Task II • Color of My Skin

22. Parent Domains and Measures • Parent Practice Interview (PPI) • Involve Parent Questionnaire (IPQ) • Parent Experience of Racial Socialization (PERS) • Parent-Child Race-related Observational Measure (PC-ROM) • Afro-centric Home Environment Inventory • Multidimensional Inventory of Black Identity (MIBI) • Parent Stress Index (PSI) • Inventory of Race Related Stress (IRRS) • Parenting Practices • Parent Racial Socialization • Parent Racial Identity • Parent Functioning

23. Means for Parenting Practices and parent-rated child behavior for control and intervention: Parenting Practices

24. Means for Parenting Practices and parent-rated child behavior for control and intervention: Parents Experience of Racial Socialization

25. Means for Parenting Practices and parent-rated child behavior for control and intervention: Child Conduct Problem

26. Means for Parenting Practices and parent-rated child behavior for control and intervention: Child Social Competence

27. Conclusion • BPSS is a model for incorporating culturally relevant content and processes into established evidence-based interventions. • BPSS is a promising preventive intervention with encouraging preliminary data. • The feasibility as been established. • A preliminary evaluation of BPSS via a randomized wait list control pilot is complete. • Significant results in positive changes in parenting, including reduction in harsh discipline, increase in use of positive racial socialization strategies, and positive changes in social and racial competence in African American children. Coard, S., Foy-Watson, S., Zimmer, C., & Wallace, A. (accepted with revision). Considering culturally relevant parenting practices in intervention development and adaptation: A randomized control trial of the Black Parenting Strengths and Strategies (BPSS) Program. Journal of Counseling Psychology

28. Racial Socialization • The Parent-Child Race-Related Observational Measure (PC-RROM), a parent-child observational measure of the race-related communication and interaction (racial socialization) has been developed and preliminary psychometrics conducted. Future Research… • Examine other sources of racial socialization beyond parents. • Investigate the ethnic variation among families of African descent in America. • Identify racial socialization practices and strategies that are associated with the most positive child outcomes taking into consideration ecological environment. • Continue to develop and evaluate race socialization interventions.

29. Show me the money:Quest for additional funding

30. Culturally Relevant Family Focused Interventions (R34) Randomized clinical trial • Condition 1: A well-established, evidence-based program for use with diverse families (Parenting the Strong-Willed Child); • Condition 2: A culturally specific adaptation of that program tailored for African American parents (Black Parenting Strengths and Strategies). • Condition 3: Information-only control Determine added benefit of cultural enhancements No randomized control trial of this nature has been conducted to date.

31. Efficacy of Cultural Adaptations for Enhancing Behavioral Health in Black Youth (R21) • A randomized clinical trial • Determine whether the addition of racial socialization content and strategies to an empirically-based intervention significantly improves service outcomes: Program Engagement (recruitment, retention, participation), Consumer Satisfaction when used with African American families.

32. Cultural Strategies for Preventing Conduct Problems: A follow-up Study (R03) • To identify any long-term trends of the BPSS intervention. • In addition, child mental health service utilization among intervention participants will be assessed.

33. Reducing Behavioral Health Disparities for Black Youth (SBIR Phase 1) • To develop and test a child-focused intervention curriculum specifically designed to be culturally relevant and effective for African American youth (K-2). Black Parenting Strengths & Strategies—Child (BPSS-C)

34. Reducing Behavioral Health Disparities for Black Adolescents (Planned SBIR Phase 1) • To adapt curriculum to be developmentally appropriate and effective for parents and adolescent. • Black Parenting Strengths & Strategies—Adolescent (BPSS-A) • Black Parenting Strengths & Strategies—Teen Parent (BPSS-TP)

35. BPSS Special/Advanced Topics • Build on BPSS to address social-familial issues and provide brief parent and/or child-directed training on specialty topics currently beyond the scope of the base program. • 3-4 sessions Assist to Resist: A Culturally Relevant Drug Prevention Program • Specifically, focuses on the development of supplemental parenting modules designed to prevent substance use in Black youth (currently funded by NIDA-Duke Transdisciplinary Prevention Research Center). Others planned: Anointed 2 Achieve: A Culturally Relevant Academic Efficacy program Embrace ME: A Culturally Relevant Self and Body Image program for girls

36. Experiences of Racism and Mental Health Outcomes During Middle Childhood (R01) The aims of this research project are as follows: • To gain an understanding of the prevalence of perceived racism experiences and how African American youth and parents perceive, interpret, conceptualize, and process racism (i.e., racial bias, racial discrimination, prejudice) in their lives (school and neighborhood settings). • To gain understanding of the impact of racism on mental health outcomes in children (i.e.., externalizing and internalizing) • To gain understanding on how those experiences and their impact may differ in African Americans across gender, age, socioeconomic status. • To elucidate the moderating role of child and parent characteristics (racial identity), family (e.g., racial socialization, SES) on experience of racism.

37. THANK YOU!!