Family-Centered Prevention Attenuates the Association Between Structural Racism Risk and Black Adolescents’ Low Self-regulation and Externalizing Behaviors: Secondary Analysis of a Randomized Clinical Trial

Abstract

Converging evidence underscores the influence of structural racism on the emergence of externalizing behaviors among Black youth. Recent studies suggest that family-centered prevention may attenuate some of the effects of structural racism on youth mental health. Hypotheses were tested regarding the potential of the Strong African American Families (SAAF) preventive intervention (ClinicalTrials.gov Identifier: NCT03590132) to (a) attenuate the influence of structural racism on low self-regulation, (b) attenuate the influence of low self-regulation on externalizing behaviors, and (c) disrupt the pathway from structural racism to externalizing behaviors via low self-regulation. Hypotheses were tested with data from 472 Black youth (mean age = 11.61 at pre-test) and their caregivers participating in a randomized prevention trial. Structural racism was indexed according to a cumulative risk model based on census-level indicators of Black-White disparities in labor force participation, housing, educational attainment, poverty, and a measure of racial segregation. Consistent with hypotheses, we found that SAAF buffered the influence of structural racism risk on low self-regulation. A significant buffering effect was not detected on the path from low self-regulation to externalizing behaviors. Conditional indirect effect analysis suggested that attending SAAF disrupted the pathway linking structural racism to externalizing behaviors via low self-regulation. Study findings underscore the potential benefits of widespread dissemination of family-centered prevention targeting evidence-based protective processes designed for Black youth. Clinical Trial: Registered at Clinicaltrials.gov, NCT03590132, July 5, 2018.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11121-025-01828-5.

Introduction

Conduct problems disproportionately affect Black1 adolescents’ development compared to their peers from other racial/ethnic groups (Danielson et al., 2021). Conduct problems are characterized by actions that violate societal norms or rules; they range from moderate instances of aggression and defiance to conduct disorders and delinquency. There is mixed evidence regarding whether or not Black adolescents engage in more problem behavior than their peers (Kim & Hong, 2024). Compared to their White peers, however, Black adolescents’ behavior is more likely to be interpreted as disruptive or dangerous (Abrams et al., 2021; Perillo et al., 2023), leading to disparities in rates of school suspension and expulsion, referrals to juvenile justice systems, and incarceration in juvenile justice facilities (Burriss et al., 2011; Nowicki, 2018; Puzzanchera et al., 2018). This underscores the importance of investigating routine forms of externalizing behavior among Black youth that may (a) place them at risk for disproportionate reactions or (b) presage future externalizing problems.

Converging evidence underscores the influence of anti-Black racism on the emergence of more severe externalizing-related outcomes (suspensions, incarceration) Black youth experience (Weinberger, 2023). Racism is a system of hierarchical categorization of socially constructed “racial” groups for differential allocation of status, resources, and power in ways that privilege White Americans (Harrell, 2000). It comprises a multilevel, multidimensional, and immersive context, systematically producing racial disparities over the life course and across generations (Gee & Hicken, 2021; Gee et al., 2012). At the individual and interpersonal levels, racism includes personal experiences of unfair treatment based on perceived race as well as exposure to marginalizing messages and stereotypes in everyday life and media contexts. Unlike individual racism, which focuses on personal prejudices and discriminatory actions, structural racism is rooted in the policies, practices, and cultural norms of institutions that advantage one racial group while disadvantaging others (Gee & Hicken, 2021). Although studies have revealed the influence of interpersonal racism on mental health outcomes, in recent years there has been a growing emphasis on the importance of examining the influence of structural racism on adolescent development due to its increasing acknowledgment as a fundamental cause of health inequities (Neblett Jr. & Neal, 2022; Williams & Mohammed, 2013).

Three conceptual pathways inform the influence of racism on externalizing behaviors. First, institutional practices and individual biases lead to authority figures over-interpreting Black youths’ behavior as oppositional or aggressive (Abrams et al., 2021), which can become a self-fulfilling prophecy as youth experience the frustration of stigmatization (Haney-Caron & Fountain, 2020). Second, instances of interpersonal and “everyday” racial discrimination evince consistent links with externalizing symptomology (Benner et al., 2018; Lanier et al., 2017; Smith-Bynum et al., 2014; Vines et al., 2017). Third, racism fosters externalizing behaviors by promoting a proliferation of stressful and traumatic experiences associated with poverty, neighborhood disorganization and crime, underfunded schools, and limited opportunity (Ursache et al., 2022; Williams, 2018). Structural racism increases coping demands, which undermine self-regulatory processes associated with behavioral and emotional self-regulation (Gibbons et al., 2012; Seaton, 2020) which serve as proximal risk factors for externalizing problems.

To date, research on these processes has focused primarily on institutional practices funneling Black youth into the juvenile justice system (Abrams et al., 2021), or linking exposure to individual racial discrimination to externalizing symptomatology (Cave et al., 2020). Linking quantitative indices of structural racism, however, to individual youths’ self-regulatory difficulties and externalizing behaviors is scarce. Moreover, recent studies suggest that family-centered prevention may attenuate some of the effects of racism on youth mental health (Brody et al., 2021; Kogan et al., 2023). For example, Kogan et al. (2023) found that among youth in a trial of the Strong African American Families (SAAF) program, self-reported racial discrimination was linked to increased depression. Comparing prevention and control groups, however, revealed that for youth experiencing SAAF, the negative impact of racial discrimination was attenuated. Other research detected similar effects in family-centered trials (Brody et al., 2021). Although this emerging research sends a powerful message regarding the potential for prevention to attenuate the effects of discrimination, these studies neglect the influence of structural racism. The potential for family-centered prevention to attenuate the effects of structural racism via effects on self-regulatory processes has not been investigated. We address this need in the present study.

Figure 1 presents study hypotheses. We hypothesize that exposure to structural racism risks will promote low self-regulation among youth, which operates as a proximal risk factor for externalizing behaviors. Family-centered prevention is expected to attenuate the effects of (a) structural racism risk on low self-regulation, (b) the effects of low self-regulation on externalizing behaviors, and (c) disrupt the indirect effect pathway. Empirical and theoretical support for these pathways follows.

Fig. 1.

Conceptual model of study hypotheses linking structural racism risk to externalizing behavior

Structural racism rests on oppressive practices in and interconnections among societal institutions (i.e., employment, housing, education) that comprise a multilevel context of oppression. Quantifying structural racism quantitatively is a scientific challenge (Neblett Jr. & Neal, 2022). Promising strategies involve place-based indicators of disparities across economic, social, and other domains (e.g., racial segregation, economic disparities, school discipline disparities) (LaFave et al., 2022). Variability in place-based characteristics at varying geographical units (state, county, school district, census tract) is associated with a range of health and other racial disparities (Bailey et al., 2017; Coke & Hayman, 2021; Mesic et al., 2018). Capturing the synergistic effects of structural racism quantitatively, however, is an ongoing challenge (Gee & Hicken, 2021). Structural racism is not simply the average of the disparities observed in a specific place. Institutional practices across domains amplify the marginalizing effects of racism (LaFave et al., 2022). Given the lack of widely accepted measures (Tiwari et al., 2024), and concerns regarding underestimating the influence of structural racism, we adopt a cumulative risk model (Clarke et al., 2014). That is, an individual’s risk for exposure to structural racism may be indexed by the accumulation of place-based risk factors that are theoretically and empirically linked to racial disparities.

We hypothesize that structural racism risk forecasts increases in externalizing behaviors indirectly, by increasing low self-gulation. Low self-regulation is the inability to regulate one’s actions, impulses, or emotions in line with societal norms or personal goals (Billore et al., 2023). It involves difficulties inhibiting inappropriate behaviors, delaying gratification, and considering long-term consequences. Low self-regulation is a robust antecedent of externalizing behaviors (Robson et al., 2020; Wills et al., 2016). Prospective research suggests that individual-level racism undermines the development of self-regulation among Black adolescents (Gibbons et al., 2010, 2012). The multiple barriers to successful life paths that structural racism creates are thought to induce frustration and require high levels of cognitive reserve to cope, thus undermining self-regulation (Adkins-Jackson et al., 2024). Other research links contextual adversities associated with structural racism (poverty, community disorganization, adverse life events) to decrements in self-regulation (Duckworth et al., 2013; Palacios-Barrios & Hanson, 2019). Neighborhood-level inequities may affect self-regulation via multiple pathways, including dysregulation in stress physiology, exposure to toxicants, or limited access to inputs necessary for healthy growth and development (Ursache et al., 2022).

Family-centered prevention is hypothesized to attenuate the pathway from structural racism risk to low self-regulation. Powerful factors affecting the influence of contextual adversity originate in the family environment. Among Black youth, caregivers’ support and nurturance, consistent discipline and monitoring, and positive messages about Black identity can attenuate the influence of adverse environments in general (Beale Spencer et al., 2015; Hardaway et al., 2016) and individual discrimination in particular (Cooper et al., 2013; Dotterer & James, 2018), on youth development. Several recent analyses of prevention trial data suggest that family-centered interventions that target these factors may attenuate the influence of racial discrimination on youth mental health (Berkel et al., 2022; Brody et al., 2021; Kogan & Reck, 2023; Lei et al., 2021). Other studies find family-centered prevention can mitigate some of the effects of community-level risks associated with structural racism risk such as community violence and negative life events (Brody et al., 2019, 2020).

Per Fig. 1, we further hypothesized that assignment to family-centered prevention would attenuate the influence of low self-regulation on externalizing behaviors. Past research finds that for youth with self-regulatory problems, including trait impulsivity and attention deficit disorder symptomology, aspects of the family environment can mitigate the influence of these vulnerabilities on externalizing problems (Duh-Leong et al., 2020; Dvorsky & Langberg, 2016; Lanza and Drabick, 2011a). For example, among children exhibiting impulsive or hyperactive behaviors, those whose families engaged in consistent routines were less likely to have oppositional defiant disorder in adolescence (Lanza and Drabick, 2011b). Structured routines may have increased the predictability of cues in the child’s environment and/or provided additional external controls on behavior that minimized the potential for externalizing problems in adolescence. Other research finds that consistent nurturing behavior is a particularly powerful predictor of reduced misbehavior and externalizing among children high in impulsivity (Stewart et al., 2024). Similarly, parental monitoring reduces risk behavior among youth with impulsive personality traits (Thompson et al., 2015).

We investigated the protective effects of family-centered prevention in the context of a randomized prevention trial of the Strong African American Families (SAAF) program. SAAF is a 7-session, 14-h family skills training program designed for Black American families with an early adolescent youth. The curriculum targets enhancing well-validated protective processes that support adolescent development in the context of challenging environments. These include racial socialization, consistent discipline, parental nurturance and warmth, and a positive Black identity. SAAF has proven efficacious in three trials in enhancing family protective processes, youth self-regulation, and deterring substance use (Brody et al., 2012a; Brody et al., 2004, 2006a, 2006b, 2005; Kogan et al., 2016, 2019). Importantly, recent analyses of trial data suggest that SAAF can attenuate the influence of individual-level racial discrimination on youths’ mental health (Kogan et al., 2023).

The Present Study

The potential for family-centered prevention in general, and SAAF in particular, to attenuate the influence of structural racism risk on low self-regulation and externalizing behaviors has not been investigated. Per Fig. 1, we tested 3 hypotheses with data from 426 Black families participating in a randomized trial of SAAF. We hypothesized that assignment to SAAF would buffer the effects of structural racism risk on increased low self-regulation. Specifically, we expected that structural racism would have a reduced association with low self-regulation in the SAAF group vs the control group. We further hypothesized that SAAF would buffer the influence of low self-regulation on externalizing behaviors. Finally, we expected that assignment to SAAF would disrupt the racism risk→low self-regulation→externalizing behavior pathways found in the control group. To strengthen inferences regarding structural rather than personal factors explaining our results, we controlled for individual-level racial discrimination. We also enhanced the specificity of our analysis by controlling for poverty status. As we had no expectations that these pathways would be affected by gender, it was controlled as well.

Methods

Study hypotheses were tested with a secondary analysis of trial data investigating the efficacy of SAAF. Details regarding the trial may be found elsewhere (Kogan et al., 2019) and in Supplement S1. Youth and their primary caregivers (N = 472 families) were recruited from eight rural counties in Georgia. School districts provided lists of Black American fifth-grade students whose parents were contacted in random order to discuss participation. Eligibility requirements were the presence in the family of a youth 11 or 12 years of age at pretest who self-identified as African American or Black. Recruitment began on June 7, 2013, and data collection concluded on December 10, 2017. Of the 825 families screened for eligibility, 625 were eligible to participate; 472 were enrolled in the trial (a 76% recruitment rate; Supplement S2).

Youth’s mean age at the baseline assessment was 11.61 years (SD = 0.62). Families had an average of 2.9 children. In 50.8% of these families, the target child was female. The primary caregivers in 88.6% of the families were the youth’s biological mothers, 5.3% were grandmothers, and 3.0% were biological fathers. The caregivers’ mean age was 37.2 years (SD = 8.74). Of the caregivers, 18.2% had less than a high school education, 26.5% had completed high school or obtained a GED, and the remaining 55.3% had at least some college education. A majority of participating families, 64.4%, had family incomes below the federal poverty threshold.

After enrollment and a baseline assessment (Time 1[T1]), participants were assigned randomly to SAAF (n = 252) or to a no-treatment control group (n = 220). Families completed follow-up assessments at 22 months post-baseline (T2), and 34 months post-baseline (T3). The overall trial design included a second intervention implemented randomly after the T3 follow-up (see S1); we focus here on the effects of SAAF solely, from T1 to T3. Black American field researchers made home visits to collect data using audio computer-assisted self-interviews on laptop computers. Retention from T1 to T3 was 91.7%; retention rates were similar across experimental groups. Informed consent/assent was obtained at all data collection points. Caregivers were paid $100, and youth were paid $40 at each assessment. All study protocols were approved by the university Institutional Review Board (IRB).

Externalizing Behaviors

At T2 and T3, externalizing behaviors were assessed with five items specifically developed for the assessment of behaviors targeted in the SAAF program. The items were “I sneak out of the house,” “I go places I am not allowed,” “I hang out with kids I am not allowed to,” “I can get out of being punished,” and “I have used cigarettes, alcohol, or marijuana.” The response scale ranged from 1 (not at all true) to 4 (very true). These externalizing behaviors were operationalized as a latent variable. Because these items lack prior validation evidence, we conducted a confirmatory factor analysis (CFA; see results below). The items evinced theoretically expected associations with low self-regulation (see Table 1), supporting their suitability in assessing externalizing behaviors.

Table 1.

Correlations, means, and standard deviations of study variables

	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17
Time 1
1. Intervention Status (1 = SAAF)	–
2. Structural Racism Risk Index	0.07	–
3. Low Self-Regulation	0.05	0.00	–
Time 2
4. Low Self- Regulation	0.02	0.08	0.55**	–
5. “… tried alcohol, cigarettes or marijuana”	0.01	− 0.03	0.19**	0.20**	–
6. “…sneak out of the house”	0.02	− 0.02	0.11*	0.11*	0.24**	–
7. “ …get out of being punished”	− 0.02	0.01	0.15**	0.14**	0.19**	0.14**	–
8. “…go places I am NOT allowed to go”	− 0.02	0.02	0.21**	0.16**	0.27**	0.47**	0.26**	–
9. “… hang out with kids …”	0.03	− 0.03	0.19**	0.24**	0.17**	0.37**	0.23**	0.55**	–
Time 3
10. “…tried alcohol, cigarettes or marijuana”	− 0.01	− 0.03	0.18**	0.22**	0.48**	0.16**	0.10*	0.15**	0.16**	–
11. “…sneak out of the house”	− 0.01	0.02	0.21**	0.23**	0.28**	0.29**	0.14**	0.22**	0.24**	0.25**	–
12. “…get out of being punished”	− 0.07	0.09	0.16**	0.17**	0.25**	0.13**	0.32**	0.17**	0.17**	0.20**	0.35**	–
13. “…go places I am NOT allowed to go”	− 0.09	0.01	0.25**	0.27**	0.13**	0.18**	0.14**	0.19**	0.17**	0.25**	0.43**	0.37**	–
14. “…hang out with kids …”	− 0.04	0.02	0.24**	0.29**	0.13**	0.24**	0.16**	0.20**	0.28**	0.23**	0.44**	0.37**	0.70**	–
Covariates
15. Poverty (T1)	− 0.01	0.12*	0.04	0.07	0.00	− 0.01	0.12*	0.07	0.07	0.03	0.07	0.10	0.07	0.08	–
16. Sex (1 = female)	− 0.06	− 0.06	0.08	0.05	0.02	0.17**	0.02	0.17**	0.14**	− 0.07	0.09	0.01	0.12*	0.11*	0.03	–
17. Interpersonal racism (T2)	0.06	0.00	0.25**	0.20**	0.12*	0.21**	0.11*	0.19**	0.16**	0.09	0.19**	0.16**	0.12*	0.14**	0.06	0.10*	–
Means	0.54	1.54	0.00	0.00	0.24	1.17	1.89	1.29	1.42	0.32	1.25	1.88	1.29	1.43	0.69	.51	20.17
Standard deviations	0.50	1.32	1.50	1.50	0.65	0.58	1.02	0.73	0.82	0.69	0.69	0.99	0.74	0.83	0.47	.50	9.20

*p < 0.05 (2-tailed); **p < 0.01 (2-tailed)

Structural Racism Risk

We linked participants’ census tracts at T1 to place-based indicators of structural racism specified by Mesic et al. (2018). Accurate address information was provided by 458 participants. Missing data due to lack of a valid address was not associated with any study variables. Participants resided in 49 different census tracts at T1. Structural racism indicators included Black-White disparities in poverty, rental housing, labor force participation, household income, and educational attainment and racial segregation. Residential segregation by race was assessed with the dissimilarity index (Bureau, 2021) which is the percentage of a group’s population (in our case, Blacks) that would have to change residence for each neighborhood (in our case, census blocks) to have the same percentage of that group as the metropolitan area (in our case, census tract) overall, i.e.,

$$\frac{{\sum }_{i=1}^n\left(t_i,\left|p_i,-,P\right|\right)}{2TP\left(1,-,P\right)}$$

where, n = number of census blocks within the census tract, t_i = total population of census block “i”, p_i = proportion of the census block’s population that is minority, P = proportion of census tract’s population that is minority, and T = total population of census tract. The dissimilarity index ranged from 0 to 100, where a higher value indicated higher segregation between races.

Black-White disparities in poverty, rental housing, labor force participation, and educational attainment were the ratio of the proportion of blacks to the proportion of whites living under the poverty level, living in rental housing, not participating in the labor force, and without a college degree, respectively. Whereas the Black-White disparity in household income was the ratio of White median annual household income to black median annual household income. All of these indices were calculated at the census tract level.

Adopting an additive risk model per our discussion in the introduction, we created a structural racism risk index by dichotomizing each factor. This decision was supported by the lack of strong intercorrelations among the indicators (avg r = 0.21). Due to the lack of natural cutoffs, we elected to use a conservative approach to strengthen inferences regarding the presence of risk; each factor was dichotomized based on a quartile split (top quartile = the risk was present [1], lower quartiles = risk not present [0]; (Gelman & Park, 2009). We then summed across structural racism risk indicators (range = 0–6).

Low Self-regulation

Low self-regulation was assessed from youth and caregiver perspectives at T1 and T2. Youth completed the low self-regulation subscale of Wills’ measure (Wills et al., 2007). The 8-item subscale included items such as “I have to have everything right away,” “I often do things without stopping to think,” and “I often get involved in things I later wished I could get out of.” Youth responded on a scale ranging from 1 (not at all true) to 4 (pretty true). Cronbach’s alphas were 0.80 at T1 and 0.73 at T2. Parents completed the low self-regulation subscale from Humphrey’s measure (Humphrey, 1982). The 6-item subscale included items such as “How often is your child distracted from work or responsibilities?” How often does your child make careless mistakes because he/she rushes?” and “How often does your child have to have things right away?” Cronbach’s alphas were 0.80 at T1 and 0.74 at T2. The scales were significantly associated (T1 r = 0.33, p < 0.001, T2 r = 0.30, p < 0.001) and thus were averaged to form a multi-reporter indicator of self-regulation at T1 and T2.

Covariates

Youth identified as male or female (non-binary information was not collected in this study). Parents provided their monthly income from which poverty status was coded at T1. At T2, youth completed the 13-item Racist Hassles Scale ((Brody et al., 2006a, 2006b); alpha = 0.95). Example items include “How often have you been blamed for something or treated suspiciously (as if you have done something or will do something wrong) because of your race?” How often did others respond to you as if they were afraid because of your race? And “How often have you been watched or followed while in public because of your race?” The time frame was the past six months; respondents answered on a scale ranging from 1 (never) to 4 (frequently).

Plan of Analysis

Moderated mediation analyses were conducted in the structural equation modeling framework using Mplus (version 8) within a structural equation framework (Muthén & Muthén, 2009). Participant attrition was not associated with study variables, suggesting that the data was suitable for full-information likelihood estimation (Enders, 2001). Model fit was assessed using multiple fit indices. Comparative fit index (CFI) values greater than 0.95, root mean square error of approximation (RMSEA) values less than 0.08, and a chi-square/degrees of freedom (χ²/df) ratio less than 3.0 were used as indicators of good model fit (Hu & Bentler, 1999). Preliminary analyses included a CFA of the latent outcome with a test for invariance across the intervention and control group, and across time longitudinally. Hypotheses were tested with multi-group path analyses comparing the Structural Racism RiskLow Self Self-regulationExternalizing Behavior pathway based on random assignment to SAAF vs Control. Direct and indirect pathways, including the covariates (sex, T2 interpersonal racial discrimination, T1 SES risk), were entered simultaneously. Conditional indirect effects were estimated with 10,000 bootstrapped samples, and significance was determined using a 95% confidence interval. All analyses were clustered based on census tract membership. Model pathways were compared using a log-likelihood ratio test (Satorra, 2000). Autoregressive controls for one year prior were included for low self-regulation and externalizing behaviors.

Results

Study variables’ means, standard deviations, and associations are presented in Table 1. A unidimensional CFA of the externalizing behavior data fit well at T2: χ² (5) = 9.87, p < 0.001, RMSEA = 0.05, CFI = 0.95, and at T3: χ² (5) = 0.50, RMSEA = 0.05, CFI = 0.98. The factor loadings ranged from 0.32 to 0.83, were significant (p < 0.05), and loaded on the latent factor in the expected direction. Examination of metric invariance with multi-group analyses revealed no significant differences in item loadings for the SAAF and control groups at each wave T2: Δχ²(4) = 2.50, p = 0.64 and T3: Δχ²(4) = 4.34, p = 0.36. Additionally, no significant differences in item loadings were detected longitudinally across T2 and T3: Δχ²(4) = 10.14, p = 0.21.

Figure 2 presents the test of study hypotheses. The model fit the data well: χ2 (193) = 342.73, RMSEA = 0.06, and CFI = 0.95. The structural racism index predicted an increase in youth’s low self-regulation one year later for the control group (β = 0.12, p = 0.02) but not for the intervention group (β = 0.05, p = 0.35). The link between the structural racism index and low self-regulation was significantly different between the control group and intervention group (−2LLΔ [1] = 6.10, p = 0.01). Low self-regulation significantly predicted an increase in externalizing behaviors one year later for both the control group (β = 0.35, p < 0.01) and the intervention group (β = 0.22, p < 0.01). The link between low self-regulation and externalizing behaviors was not significantly different between the control group and intervention group (-LLΔ [Δdf] = 2.1[1], p = 0.16). Bootstrapped indirect effects revealed that structural racism risk indirectly predicted increases in externalizing behaviors via low self-regulation for the control group (Est. = 0.04, 95% CI = 0.02, 0.06) but not for the intervention group (Est. = 0.01, 95% CI =  − 0.01, 0.04).

Fig. 2.

Multigroup analysis of study hypotheses. Note: Standardized estimates presented. T1 sex, poverty, and low self-regulation and T2 externalizing behavior controlled but not pictured

Discussion

Racism is a multilevel, immersive system of oppression that undermines Black Americans’ wellbeing and affects the prevalence and consequences of externalizing behaviors. This context underscores two interrelated realities. First, there is an urgent need to dismantle oppressive social structures through policy, institutional action, and advocacy to promote equity, inclusion, and social justice. Given the intransigence of anti-Black racism in US history, however, there is also an urgent need to develop, refine, and disseminate behavioral interventions that can promote Black individuals’ ability to survive, succeed, and thrive despite racism.

Extending past research that found family-centered prevention may attenuate the effects of individual-level racial discrimination on Black youths’ mental health, we investigated if assignment to the SAAF program attenuated the influence of structural racism risk on low self-regulation and of low self-regulation on misbehavior. Our analysis controlled for individual-level discrimination to better support inferences specifically regarding structural influences. Consistent with hypotheses, we found that for youth in the control group, structural racism risk promoted problems with self-regulation; conversely, this link did not manifest for youth assigned to SAAF. The difference between experimental groups in the prospective association of structural racism risk and low self-regulation was statistically significant, suggesting a buffering effect of the structural racism➜low self-regulation association. Conditional indirect effect analysis revealed a significant indirect effect linking structural racism to externalizing behaviors via low self-regulation for the control group, but not for the SAAF group.

The study findings are consistent with prior empirical research, which shows that Black youth benefitted from a significant buffering influence due to their participation in family-centered prevention. These effects have been detected in the context of exposure to individual-level racial discrimination (Berkel et al., 2022; Brody et al., 2021; Kogan et al., 2023; Lei et al., 2021) and neighborhood-level risk factors (Brody et al., 2019, 2020). We extend these findings specifically to the potential influence of structural racism risk on low self-regulation and externalizing behaviors. Together, these findings are noteworthy given their investigation in five different randomized trials with four different intervention programs. All are relatively brief (5–7 sessions, 10–14 h) skills-based programs. These programs address early and middle adolescent youth, targeting a range of protective factors associated with healthy adolescent development among Black youth including parental racial socialization, effective parenting and co-parenting practices, and positive Black identity. Notably, these programs represent culturally and ecologically tailored interventions rather than generic or surface adaptations of interventions for Black youth. This accumulating body of studies underscores the potential of widespread dissemination of family-centered prevention designed specifically for Black youth.

Study findings are consistent with decades of research across diverse social science disciplines underscoring the power of family relationships and parenting practices to shield children and youth from the influence of contextual adversity on development (Lynch et al., 2021). Despite increasing individuation in adolescence, family dynamics and parenting processes profoundly shape adolescents’ development and response to contextual adversity. Although racism is deeply embedded within US society (Breland & Stanton, 2022; Buggs et al., 2020), Black families are not passive recipients of social inequities. They actively challenge the demands of racism in their lives, which includes the development of responses to navigate racism in ways that support youth development (Wint et al., 2022) and contest the assumptions of racist hierarchies (Anderson, 2019; Payne & Brown, 2010). Study findings support the design, implementation, and dissemination of prevention strategies that target evidence-based protective processes such as racial socialization, effective parenting practices, and racial identity. An important caveat must be noted. A sole focus on augmenting protective processes among minoritized youth risks a subtle form of racism and stigmatization where lay audiences may suggest that the “answer” to racism is “empowering” those who must cope with systemic inequity. We contend that empowerment must be only one strand of a larger policy mandate that targets structural and institutional racism.

Contrary to study hypotheses, we did not find that SAAF moderated the influence of low self-regulation on internalizing. Although the strength of the association was reduced in the SAAF group, the comparison of coefficients was not statistically significant. The direction of the effects, however, is promising, and investigation with larger samples is warranted in future research. The potential for this kind of effect bolsters the potential utility of family-centered prevention to operate in indicated prevention contexts with youth who already evince vulnerabilities. Investigation of buffering effects in general, and those related to social inequities in particular, provides a novel method for evaluating the value of an intervention, extending how effectiveness is understood (Brody et al., 2012b). In the context of multi-component interventions with multiple intervention-targeted mediators, direct effect analyses may be limited. As multiple pathways and risk factors are associated with misbehavior, externalizing problems, and other outcomes, interventions may (a) benefit children in different ways and/or (b) achieve benefits via different mediating pathways. From this perspective, prevention programs may be considered a set of resilience resources rather than a singular intervention designed to change a specific risk factor and outcome. It may be the case that the question of under what contextual circumstances an intervention was helpful is as informative as finding a direct effect.

Strengths and Limitations

We assessed structural racism using a cumulative, place-based risk model. To date, studies that operationalize structural racism risk using place-based data and linking this variability to individual-level behavior (rather than area rates of disease or crime) are scarce. Integrating a place-based metric of structural racism risk in the context of prevention trial data is novel. We acknowledge, however, that this is a rapidly developing area and that novel metrics and new indicators are being examined. Future research is needed that considers alternative models of structural racism, including consideration of sub-factors and profiles and interactions between indicators.

We developed a latent variable for externalizing behaviors with items derived from a project-developed scale. Future research would benefit from the use of standardized measures and multiple reporters. Although we used items developed to assess intervention targets linked to externalizing risk, there are benefits to this approach in the context of a prevention study. Rather than assessing potential psychopathology, we focused on routine and common behavior that, while externalizing in nature, does not necessarily suggest disorder. This allows us to better consider how structural racism may influence youth behavior in a community sample where high rates of serious externalizing problems would not be expected. This is particularly important with young Black adolescents for whom the impact of externalizing behaviors may be amplified by structural racism. Notably, our latent construct fit the data well, was invariant longitudinally and across experimental groups, and the items evinced theoretically expected associations with low self-regulation. Additional research is also needed that considers a range of potential mechanisms through which family-centered intervention attenuates the influence of structural racism. Finally, the sample was composed of rural families in Georgia; findings may not generalize to other geographic regions.

Supplementary Information

Below is the link to the electronic supplementary material.

Author Contribution

SMK conceptualized the study, secured funding and supervised the collection of the data, and constructed the first draft of findings. AJR conducted statistical analyses of the hypotheses and contributed to manuscript revisions. BP created census-based variables and contributed to manuscript revisions. JRP co-conceptualized census-level hypotheses and contributed to manuscript revisions. SC, AO, SRHB, KK, SJA, SF, EM, and LZ contributed to interpretations of study findings, implications for the field and future research, and contributed to manuscript revisions.

Funding

Dr. Kogan was a principal investigator of the grant in which this research was supported, Award Number R01AA021774 from the National Institute on Alcohol Abuse and Alcoholism and was co-investigator on a second grant that supported this research, Award Number P50DA051361 from the National Institute on Drug Abuse. The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, or the National Institutes of Health.

Declarations

Ethics Approval

Study procedures were approved by the University of Georgia Institutional Review Board, Approval number 2013–10040. We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to Participate

Written caregiver consent for self and child was obtained along with written assent from child participants.

Conflict of interest

The authors declare no competing interests.