JMIR Publications

ABSTRACT

Background:

Nearly one in five Black Americans are first- or second-generation immigrants; however, little research to date focuses on the experiences of these communities in a disaggregated and culturally specific way. Emerging adults (ages 18-29) from Black immigrant backgrounds face multiple intersecting challenges to their mental health as they try to transition to adulthood and develop their identity, all while navigating intergenerational traumas from the immigration process and ongoing challenges faced as Black people in the United States. Our preliminary research has identified significant mental health disparities affecting Ethiopian and Eritrean emerging adults in Atlanta. Despite these threats to mental health and well-being, and the growing representation of Ethiopian, Eritrean, and other immigrant groups within the larger Black population, there are no evidence-based interventions that have been developed or tested specifically for Black immigrant emerging adults.

Objective:

This study aims to develop and pilot-test Weyera, a novel group-level intervention facilitated by trained peer facilitators, to enhance resilience and improve mental health in this population. In phase 1, we will develop Weyera, a culturally responsive mental health support intervention for Ethiopian and Eritrean emerging adults. In phase 2, we will conduct a pilot trial of Weyera to evaluate feasibility, acceptability, and safety.

Methods:

In phase 1, we will use the Intervention Mapping approach and work with our established Youth Advisory Board (comprised of Ethiopian and Eritrean emerging adults) to refine an intervention outline and develop objectives and activities through a participatory, iterative process. In phase 2, we will pilot Weyera in a randomized waitlist-controlled trial, with participants randomized upon enrollment to an immediate intervention group or a delayed intervention (wait-list control) group. Participants will attend a two-hour weekly group session for eight weeks. Our evaluation will primarily focus on feasibility, acceptability, and safety, while also exploring potential intervention impacts on hypothesized effect modifiers (e.g., resilience processes such as social support, affirming ethnic identity, and mental health service utilization) and mental health outcomes (e.g., depression, anxiety, and trauma). We will assess our primary and secondary outcomes using mixed-methods, including serial surveys as well as qualitative exit interviews, and we will also conduct process evaluations to monitor fidelity and adoption.

Results:

Phase 1, the development of Weyera activities began in January 2025 and was completed in the summer of 2025. Phase 2, the implementation of the Weyera waitlist control trial, commenced in September 2025 and is projected to be finalized by April 2026. The final results are expected in Summer 2026.

Conclusions:

The trial is poised to demonstrate that the Weyera intervention is feasible, acceptable, and safe among Ethiopian and Eritrean immigrant youth. This work will add to the knowledge of using group-level interventions facilitated by trained peer facilitators to enhance resilience and improve mental health in this population. Clinical Trial: Trial Registration: https://clinicaltrials.gov/study/NCT06960187