Culturally Tailored ACT for Black Trauma

Summary

Blacks in America more frequently meet the criteria for posttraumatic stress disorder (PTSD) than any other US race or ethnicity. Yet, blacks are among the groups least likely to use mental health services for trauma. Thus, a large number of traumatized blacks suffer silently and remain untreated.

Acceptance and Commitment Therapy (ACT) is an empirically-based psychological intervention that uses acceptance and mindfulness strategies, with commitment and behavior change strategies, to increase psychological flexibility and decrease anxiety outcomes. While culturally tailored mental health interventions have been shown useful for racial and ethnic minorities, there have been few efforts to tailor ACT for blacks. This NIH R21 would compare an ACT model specifically culturally tailored for blacks (POOF) to the classic ACT model in a randomized trial, where clinicians will conduct 12-session telehealth synchronous virtual groups. Eighty black participants who self-identify as suffering from stress or anxiety will be confidentially recruited. Two specific aims are proposed:

Aim 1) It is expected that POOF participants will report higher levels of acceptability of treatment than classic ACT participants and that POOF participants will have better adherence to treatment regimens than traditional ACT participants.

Aim 2) Given that race-based stress may mediate anxiety symptoms in U.S. based blacks, it is expected that POOF will decrease race-based stress, thereby mattering the most for improving anxiety outcomes for blacks.

The proposed R21 pilot study will be the first randomized controlled trial to evaluate an ACT intervention tailored explicitly for black racial trauma. This study will provide critical data needed to plan and design a future R01 controlled longitudinal effectiveness study. The long-term objective is to significantly reduce the prevalence of stress and anxiety-related symptoms due to traumatic events for Blacks by increasing treatment acceptability for this population. Since blacks have the highest rates of trauma prevalence and chronicity, yet they are still underrepresented in mental health treatment, this tailored intervention can have a significant public health impact.

Conditions

• Stress Disorders, Traumatic
• Anxiety
• Anxiety Disorders

Interventions

BEHAVIORAL

POOF ACT program

The goal of this study is to test this culturally tailored intervention (POOF) against classic ACT, to discover if POOF does better at decreasing race-based trauma in African Americans.Guided by the cultural humility framework and social determinants of health model, we examine POOF, a culturally-tailored ACT model for use with anxious African Americans. The POOF approach builds on research on ACT for the general population, an evidence-based intervention, by tailoring the language of ACT while retaining the fidelity of the ACT model. Our hypotheses examine acceptability and attitudes toward treatment, treatment outcomes for psychological symptoms (i.e., anxiety) and an ACT-related outcome (i.e., psychological flexibility), and a possible underlying mechanism of change (i.e., race-based stress).

BEHAVIORAL

Classic ACT program

This protocol is for a classic, non-adapted ACT intervention.

Sponsors & Collaborators

• Azusa Pacific University

  lead OTHER

Principal Investigators

• Jennifer S Payne, Ph.D. · Azusa Pacific University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

FACTORIAL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-09-01

Primary Completion

2022-09-01

Completion

2023-08-31

Countries

• United States

Study Locations