Objective: Empirically supported treatments (ESTs) have been criticized for lack of ethnoracial representation, which may limit the generalizability of findings for non-White patients. This study assessed ethnoracial representation in United States-based randomized controlled trials (RCTs) for three evidence-based treatments for posttraumatic stress disorder (PTSD)-Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Eye-Movement Desensitization and Reprocessing (EMDR). Method: Representation was measured by explicit inclusion of people of color in published PTSD RCTs. Follow-up emails were sent to corresponding authors if full demographic information was not included in the reviewed manuscripts. Information concerning participant remuneration was collected for descriptive purposes. Results: All three treatment modalities reported White participants as the majority in their sample. PE and CPT trials reported similar levels of ethnoracial diversity, while EMDR efficacy studies reported the least ethnoracial diversity. Across the reviewed studies, with few exceptions, we found low numbers of non-White participants in the majority of reviewed studies, which was compounded by poor or unclear methods of reporting ethnoracial information. Conclusions: This study demonstrates that the ESTs for PTSD are not adequately representative of the majority of non-White participants. Future RCTs should place a stronger emphasis on broad ethnoracial diversity in study participants to improve generalizability of findings. Clinical Impact StatementThis study highlights a concerning lack of ethnoracial representation in PTSD clinical trials for commonly used, evidence-based PTSD treatments. This lack of ethnoracial representation impairs our ability to detect cross-cultural differences in treatment response and offer culturally sensitive, evidence-based PTSD treatment. We encourage researchers to explicitly include larger numbers of non-White participants in PTSD clinical trials and to conduct analyses to detect ethnoracial differences in both symptom presentation and treatment response.

Context: Authentic youth engagement is widely recognized as an efficacious strategy to promote adolescent health. Program: The Providers and Teens Communicating for Health (PATCH) Youth Advocacy Fellowship was created to support Wisconsin's Adolescent Health Program. It strives to bring youth voice to the forefront of adolescent health conversations while also providing young people the knowledge, skills, and opportunities to thrive into adulthood. Implementation: The Fellowship hires and trains Wisconsin youth, aged 12 to 21 years, to be a part of community-and state-based adolescent health conversations. Youth meet regularly as a team for ongoing enrichment and are provided opportunities to consult on adolescent-focused projects and initiatives. They are also responsible for independently completing an advocacy learning series, which culminates in an advocacy plan on a topic of personal interest. The Fellowship has been implemented as an extended 9-month program, as well as an expedited 8-week pilot. Evaluation: An evaluation was conducted to compare the 8-week pilot (summer 2018) with 51 youth and the sequential 9-month Fellowship (2018-2019) with 12 youth. Based on the quantitative analysis of 2 programmatic evaluations (posttraining and postprogram), both program models showed success. Yet, there were distinct differences among self-reported youth outcomes as well as depth and extent of engagement. Across all 14 domains, the 9-month cohort demonstrated consistently higher mean scores. Half of the domains (7) showed statistically significant differences. Discussion: When considering youth engagement, it is important for practitioners to determine the goals, needs, capacity, and resources of both youth and the organization. Engaging youth for shorter-term commitments may serve as an important health education strategy, providing youth important knowledge and skills. Yet, engaging youth for extended periods of time may result in more meaningful engagement, fruitful projects, and substantial changes in positive youth development.