Pathways for African American Success: Results of Three-Arm Randomized Trial to Test the Effects of Technology-Based Delivery for Rural African American Families

Abstract

Objective The objective of this study was to test the effectiveness of a technology-based program to avert risky behaviors among rural African American youth. We hypothesized that the technology-based and group-based formats of the Pathways for African Americans Success (PAAS) program would lead to improvements in primary outcomes, and that the technology condition would perform at least as well as the group condition. Methods A three-arm Randomized Control Trial (RCT) ([N = 141] technology-based delivery, [N = 141] small group delivery, and [N = 136] literature control) was conducted with 421 sixth graders and their caregivers, Summer 2009–Fall 2012. Families were recruited from five rural counties in Tennessee and completed baseline, posttest [M = 14.5 (4.4) months after pretest] and long-term follow-up [M = 22.6 (3.7) months after posttest]. Structural Equation Modeling (SEM) was used to test intervention-induced changes in both parents and youths’ primary outcomes (pretest to posttest) and on secondary targeted outcome, youth sexual risk, and substance use patterns (pretest to follow-up). Results Parents in the technology condition reported significant increases in strategies to reduce risk. Youth in the technology condition experienced a significant decline in intent to engage in risk behaviors and reduction in substance use and sexual risk behavior. Youth in the group condition experienced a significant increase in affiliation with deviant peers. Conclusions This study provides evidence of the ability of eHealth to improve parenting and reduce adolescent engagement in substance use and sexual risk behavior. Suggestions for dissemination in schools and health-care systems are offered.

A Systematic Review of eHealth Interventions Among Adolescents of Low Socioeconomic and Geographically Remote Backgrounds in Preventing Poor Diet, Alcohol Use, Tobacco Smoking and Vaping

“…Nine trials (Cremers et al, 2015;Frenn et al, 2003Frenn et al, , 2005Lubans et al, 2016;Martinez-Montilla et al, 2020;Nollen et al, 2014;Smith et al, 2014;Tripicchio et al, 2017;Voogt et al, 2013;Wright et al, 2013) were conducted among adolescents of low socioeconomic status, four (Chai et al, 2021;Davis et al, 2016;Gustafson et al, 2019;Hongthong & Areesantichai, 2016) were among adolescents living in geographically remote areas, and one focused on adolescents of both low socioeconomic and geographically remote backgrounds (Murry et al, 2019).…”

“…Nine trials (Chai et al, 2021;Davis et al, 2016;Frenn et al, 2003Frenn et al, , 2005Gustafson et al, 2019;Lubans et al, 2016;Nollen et al, 2014;Smith et al, 2014;Tripicchio et al, 2017;Wright et al, 2013) targeted diet, three (Hongthong & Areesantichai, 2016;Martinez-Montilla et al, 2020;Voogt et al, 2013) targeted alcohol, one (Cremers et al, 2015) targeted tobacco, and one (Murry et al, 2019) targeted both alcohol and tobacco. No studies targeted vaping.…”

Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State

“…Technology-based interventions via mobile phones or tablets can potentially overcome barriers to access [23,24]. Technology-based interventions have focused on multiple outcomes including depression, cardiovascular disease, weight loss and management, and engagement in risky behaviors with successful results [25][26][27][28][29][30][31]. Specifically, mobile technology-based health (mHealth) platforms are becoming an ideal methodology for technology-based interventions due to extensive growth and expected continued growth in mobile phone, particularly smart phone, use in the US [32].…”

Introduction to the Coordinated Special Issue on eHealth/mHealth in Pediatric Psychology

“…eHealth interventions offer promise in overcoming some of the well-known challenges that frequently arise during in-person trials, namely low session attendance, variable intervention fidelity, and limited downstream scalability. Murry, Berkel, Inniss-Thompson, & Debreaux (2019) highlight that their modification of an existing family-based preventive intervention for adolescent risk behaviors to a computer-based delivery format aimed for rural African American families was efficacious in improving parenting outcomes and adolescent risk behavior. Consequently, their eHealth intervention may be an ideal candidate for scaling preventive interventions to underserved areas.…”