JMIR Publications

ABSTRACT

Background:

Black boys and men from disinvested communities are disproportionately victims, perpetrators, and witnesses of violence and homicide. Yet, they face several critical individual and systemic barriers to accessing violence prevention programs. These barriers include but are not limited to historical mistrust of legal and medical systems, structural racism, criminalization of young Black males (YBM), and gender norms that frame help-seeking as a weakness. Another re-emerging barrier is ‘service avoidance,’ a phenomenon that involves intentionally avoiding services and programs perceived to be linked to the ‘feds.’ Service avoidance contributes to recidivism, mortality, and a revolving-door approach to violence prevention (Eckhardt et al., 2013), making it challenging to implement anti-violence programs broadly and with fidelity among at-risk youth. YBM are “digital natives.” Therefore, intervening in their digital social ecology offers a pragmatic and promising opportunity to mitigate barriers to accessing prevention services while boosting service engagement. We will adapt and pilot test BrotherlyACT — an online life-skills and mindfulness coaching digital tool based on the Acceptance and commitment therapy (ACT), which has documented efficacy for violence reduction in incarcerated samples. This intervention will incorporate micromodules on life skills with interactive digital tools for risk assessment, goal setting, and safety planning, as well as a chatbot to simulate help-seeking that are easily integrated into a YBM daily lives and personalized to their individual needs.

Objective:

To systematically adapt and pilot the BrotherlyACT intervention (Building Health-Related Outcomes Using Technology for Empowerment, Risk Reduction, and Life Skills Preparation in Youth) as a culturally-congruent, trauma-focused digital tool for mindfulness and life skills coaching tailored to young Black males (YBM), ages 15-24.

Methods:

First, we will qualitatively investigate the social and structural barriers and motivators influencing YBM willingness to use violence and substance use prevention services with 15-30 YBM (ages 15-24) and ten service providers (ages 18+, any gender) (Aim 1). Then, a youth advisory board (YBM, topic experts, and service providers) will conduct concurrent co-design and rapid prototyping to systematically review BrotherlyACT adapted from an existing evidence-based program (Achieving Change Through Values-Based Behavior, or ACTV). We will employ user-centered design principles (UCD) and the ADAPT-ITT framework to guide this adaptation process (Aim 2). Finally, in Aim 3, 60 young Black males will pilot test the adapted BrotherlyACT over ten weeks in a single-group, pretest-posttest design to determine its feasibility, accessibility, and implementation outcomes. A mixed methods approach combining quantitative and qualitative analyses will be adopted.

Results:

Aim 1 data gathering began in September 2021. Aims 2 and 3 are scheduled to start in June 2023 and end in September 2024.

Conclusions:

The development and testing of BrotherlyACT is a crucial first step in expanding an evidence-based mindfulness- and skills-based intervention for violence-involved young Black males. This co-location of services shifts the conventional prevention strategy from telling YBM why to change to teaching them how. If this proof-of-concept succeeds, the adapted intervention will be tested in a larger trial to determine efficacy in reducing violence and substance use. Clinical Trial: NA