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. Author manuscript; available in PMC: 2025 Nov 14.
Published before final editing as: OTJR (Thorofare N J). 2025 Nov 10:15394492251385473. doi: 10.1177/15394492251385473

Racial Media Microaggressions: Impact on Black Adolescent Mental and Behavioral Health

Maribeth Clifton a, Richelle L Clifton b, Tamika C B Zapolski c
PMCID: PMC12614748  NIHMSID: NIHMS2114089  PMID: 41208541

Abstract

Background:

Media use is a meaningful occupation for adolescents. Black adolescents may be at risk for exposure to racial microaggressions through this occupation. Racial microaggressions are subtle forms of discrimination that negatively impact health.

Objective:

To examine the impact of exposure to racial media microaggressions on mental and behavioral health outcomes among Black adolescents.

Methodology:

A 14-day daily diary protocol was used to administer measures on racial media microaggressions, depression, anxiety, aggression, and cannabis use.

Results:

Neither concurrent nor lagged-day associations between racial media microaggressions and symptoms of anxiety, depression, or cannabis use were significant. The concurrent effect of racial media microaggressions on aggression was non-significant, but the next-day lagged effect of racial media microaggressions on aggression at both the within- (estimate=0.610, SE=0.281, t=2.170, p=0.030) and between-person (estimate=−0.364, SE=0.182, t=−2.004, p=0.046) levels was statistically significant.

Conclusion:

This study found that exposure to racial media microaggressions impacted Black adolescent behavioral health.

Plain-Language Summary

Understanding The Impact of Racial Microaggressions in the Media on Black Adolescent Mental and Behavioral Health

Media use is a meaningful occupation for adolescents. Media use includes activities such as watching online videos; watching television; and reading books, e-books, magazines, or online articles. It is important to understand how media use may impact health, especially among marginalized groups who may experience discrimination, because of their race, through the media. This study explored whether exposure to racial media microaggressions, a subtle form of racial discrimination, impacted mental health and behavioral health (depression, anxiety, aggression, cannabis use) among a group of Black adolescents. We found that on days when participants experienced more racial media microaggressions than usual for themselves, they experienced an increase in aggression the next day. In contrast, those youth who experienced more racial microaggressions compared to the other youth in the study had lower aggression the following day. We discuss how occupational therapy practitioners can consider these findings in research and practice.

Introduction

Black Adolescence and Racial Microaggressions

As adolescents transition from childhood roles and routines, they engage in increased interpersonal interactions and begin to make inferences about themselves based on others’ perceptions and attitudes (Lloyd, 2002). For Black adolescents, the intersection of their developmental stage and race adds complexity to these dynamics, as they also navigate racism. For example, adolescents belonging to marginalized racial/ethnic groups are more likely to experience discrimination compared to non-marginalized adolescents (Bogart et al., 2013). Racial discrimination, the behavioral manifestation of racism, is a frequent experience for youth of color. As Black children enter adolescence, their experiences of racial discrimination increase (Umaña-Taylor, 2016). Discrimination has been linked with poorer mental health, including depressive symptoms and anxiety (Bernard et al., 2022; English et al., 2020), decreased academic achievement (Chavous et al., 2008; English et al., 2016), substance use (Jelsma & Varner, 2020), and aggression and problem behaviors (Bogart et al., 2013). In addition to blatant, overt forms of racial discrimination (e.g., racial slurs, violent acts), more subtle, covert, and commonplace forms of racial discrimination exist, known as racial microaggressions (Su et al., 2007; Wong et al., 2014). Racial microaggressions occur more frequently than overt forms of racial discrimination and involve everyday verbal, behavioral, or environmental slights, whether intentional or unintentional, directed at people of color (Wong et al., 2014).

Sue et al. (2007) first defined and proposed categories of racial microaggressions, laying the foundation for decades of work that has expanded our understanding of these experiences. More recently, Williams et al. (2021) reexamined and resynthesized the racial microaggression literature to date, proposing a revised categorical taxonomy of racial microaggressions, including categories such as assumptions about intelligence, competence, or status; pathologizing minority culture or appearance; environmental exclusion; and environmental attacks.

Adolescent Media Use: Patterns and Racialized Experiences

Media use is a meaningful occupation for adolescents, directly connected to play, leisure, education, social participation, and beyond. In 2021, rates of daily media use among adolescents aged 13–18 years old in the United States were 77% for watching online videos, 62% for social media use, 49% for watching television, and 21% for reading books, e-books, magazines, or online articles (Rideout et al., 2022). Specific daily media usage included 1 hour and 50 minutes of television, 1 hour and 27 minutes on social media, 1 hour and 22 minutes watching online videos, and 34 minutes of reading (Rideout et al., 2022). Notably, when examining media use by race/ethnicity, Black adolescents report even higher levels of engagement across various media types, including television. Black adolescents, on average, spend 2 hours more on screen media (e.g., television, gaming, videos, browsing websites, video-chatting, e-reading) than their White peers, with a daily total of 9 hours and 50 minutes (Rideout et al., 2022). These findings underscore that Black adolescents devote substantial time to various forms of media, reinforcing it as a central occupation in their daily lives.

While media is an important context through which adolescents explore the world, learn about others, and shape their self-views (Berry, 2000), media use is sometimes associated with poor mental health outcomes. Social media and internet use have been linked to increased risks for depression, anxiety, and psychological distress (Barry et al., 2017; Keles et al., 2020), as well as behavioral outcomes including aggression and substance use (Vannucci et al., 2020). Berry (2000) highlights the role of television and emerging media in shaping the personal and social attitudes of adolescents of color, focusing on the psychosocial impact of multicultural portrayals (or their absence) on television and how these portrayals influence self-esteem, identity, and worldviews. Thus, for youth of color, racial discrimination experienced via the media may have a significant negative impact on their mental and behavioral health.

In a series of studies, Tynes et al. (2008, 2019, 2020, 2024) documented that Black adolescents exposed to online racial discrimination through internet-based platforms (e.g., text messaging, online chat, discussion forums, online games, social network sites, internet sites) were at greater risk for poor psychological functioning, including post-traumatic stress disorder symptoms, depression, and suicidal ideation. While these studies provide crucial insights into the effects of racial discrimination exposure via media on the health of Black adolescents, they primarily focus on overt forms of discrimination, such as people making demeaning comments about one’s racial background, being shown racist images, or being threatened with violence (Tynes et al., 2022).

However, in addition to these blatant and overt forms of racial discrimination, minoritized groups are likely exposed to a variety of racial microaggressions through the media, especially given their pervasive, everyday nature. For instance, an adolescent might encounter stereotypical or negative portrayals of their racial group in television shows or movies. They may see their racial identity minimized or rendered insignificant by the exclusion of depictions that represent their racial group or read about negative portrayals in books or magazines, where characters of their race may rarely hold leading or positive roles. In their review, Williams et al. (2021) highlight the relationship between young people experiencing microaggressions within everyday contexts and higher levels of depression, anxiety, post-traumatic stress disorder, impaired psychological well-being, decreased self-esteem, increased substance use, delinquency, decreased academic success, and suicidality. Despite this prevalence, research on racial microaggression exposure via the media on adolescent outcomes remains scarce.

Occupational Justice as a Framework

As a theoretical framework for conceptualizing this work, we have drawn on the concept of occupational justice. This framework highlights the injustices that persist when occupations are “barred, confined, restricted, segregated, prohibited, underdeveloped, disrupted, alienated, marginalized, exploited, excluded or otherwise restricted” (Townsend & Wilcock, 2004, p. 77). For Black adolescents, racial microaggressions contribute to occupational injustice by disrupting opportunities for positive and health promoting engagement in daily life activities (e.g., media use), thereby limiting access to meaningful and affirming occupations (Grullon et al., 2018). Beyond the disruptions to engagement, racial microaggressions influence health and quality of life through the aforementioned impacts on psychological and emotional well-being, interpersonal behaviors and functioning, academic success, and feelings of inclusion and belonging.

Despite its significance, there remains ambiguity in how to implement an occupational justice perspective within the occupational therapy profession. For example, Taff et al. (2024) conducted a review exploring occupational therapy theories, models, and frameworks for justice-oriented concepts. The review outlines that, in many instances, inclusion relates specifically to disability rather than the broader range of cultural aspects that would more fully capture a variety of life experiences, for example, those shaped by racial discrimination. Moreover, Taff and colleagues (2024) found that although justice-oriented concepts are present in occupational therapy theories, models, and frameworks, they are rarely linked to concrete interventions, educational strategies, or research questions, which may inadvertently uphold systems of power and fail to directly challenge systemic oppression within practice, education, and research. This study serves as a step towards advancing occupational rights by asking critical questions and making observations to increase understanding about the occupational injustices faced by Black adolescents, particularly those experienced through racial media microaggressions.

Study Purpose

Thus, the purpose of this study was to examine the impact of exposure to racial microaggressions—a form of racial discrimination that contributes to occupational injustice—via the media on mental and behavioral health outcomes among Black adolescents. This study employed a broad definition of media use, encompassing television, magazines, books, and movies. Given the everyday nature of racial microaggressions (Sue at al., 2007), we sought to examine Black youths’ experiences of racial media microaggressions within their natural routines and environments to capture ‘life as it is lived’ (Bolger et al., 2003, p. 579) using daily diary methodology.

Methods

The data for the current study are from a larger daily diary study examining the impact of racial microaggressions on mental and behavioral health outcomes among Black adolescents (Clifton, 2023), as well as the impact of racial identity on these relationships (Clifton & Zapolski, 2023). This study was approved by the institutional review board (IRB) at Indiana University-Purdue University Indianapolis (IUPUI).

Study Design

Daily diary methodology was used to facilitate an observational study of individual participants, with repeated measures across a 14-day period. The daily diary approach enabled real-time assessment of racial media microaggressions within participants’ daily natural context, minimizing retrospective bias and enhancing the ecological validity of the data collected. This study design allowed examination of both within- and between-person differences, offering a more nuanced and comprehensive understanding of the impact of these experiences over time (Lischetzke and Könen, 2020).

Participants and Recruitment

Eligible youth were African American/Black, between 10–19 years of age, had a cell phone for exclusive personal use with SMS (short message service) capabilities, had informed parental consent (for those under 18) and active youth assent/consent. Following IRB approval, participants were recruited from locations in and around a large mid-western city in the United States. Participants were recruited through flyering (online and in-person) and in-person recruitment efforts utilizing verbal advertisement scripts at local schools, after-school programs, and youth-serving organizations. Additionally, participants were recruited through social media advertisements.

Procedures

Eligible participants completed an orientation appointment with research staff where assent (or consent for those over 18) procedures took place. Participants were oriented to the text-message protocol and instructed on how to complete self-report baseline measures. Immediately following the orientation appointment, participants were asked to complete a brief baseline survey. The daily diary protocol began two days after the completion of the baseline survey and lasted for 14 consecutive days. Quantitative surveys (see Daily Measures section below) were administered to participants by text-messaging through Qualtrics, a software that allows for the programming and distribution of SMS text message surveys. Each day of the 14-day period, participants received an SMS prompt at 3:00pm with a link to the daily survey. Participants were delivered a follow-up reminder prompt via SMS at 7:00pm local time if they had not yet completed the survey. Participants could initiate the day’s survey until 11:59pm local time, after which time that day’s entry was no longer recorded. Only one response to the daily survey was permitted per day. The initial prompt indicated that questions referred to participants’ experiences, mood, and behavior on the previous day (i.e., “These questions are about yesterday from the time you woke up until the time you went to sleep”). Participants received an automated message within Qualtrics to complete any missing survey items, though responses were not required. The maximum compensation for participation was $68 per participant, if they completed all study procedures.

Baseline Measures Relevant to the Current Study

Demographics

Participants were asked about demographics including their age and gender.

Daily Measures Relevant to the Current Study

Racial Media Microaggressions

Racial Media Microaggressions were measured using the 4-item Media Microaggressions subscale from the Revised 28-Item Racial and Ethnic Microaggressions Scale, checklist version (REMS-Checklist; Forrest-Bank et al., 2015; Nadal, 2011). This measure was modified to ask about experiences with media microaggressions on the day prior. Questions for this measure were, “I observed people of my race portrayed positively on television,” “I observed people of my race portrayed positively in magazines,” “I read popular books or magazines in which a majority of contributions featured people from my racial group,” and “I observed people of my race portrayed positively in movies.” Response options were on a yes/no scale. For the current study, each item was reversed-scored, and a total score was created from the sum of all items. The internal consistency for this measure was good (Cronbach’s alpha=0.773).

Symptoms of Depression

Symptoms of depression were measured using the Patient Health Questionnaire, 8-item (PHQ-8; Kroenke et al., 2009). This measure was modified to ask about depression symptoms on the day prior. Participants were asked how often during the day they were bothered by particular symptoms of depression, with items including statements like “little interest or pleasure in doing things” and “feeling down, depressed, or hopeless.” Response options were a 4-point Likert scale, ranging from 0 (not at all) to 4 (nearly all day). A total score was calculated from a sum of all item scores. The internal consistency for this measure was good (Cronbach’s alpha=0.895).

Symptoms of Anxiety

Symptoms of anxiety were measured using the Generalized Anxiety Disorder scale, 7-item (GAD-7) (Spitzer et al., 2006). This measure was modified to ask about symptoms of anxiety on the day prior. Participants were asked how often during the day they were bothered by particular symptoms of anxiety, with items including statements like “feeling nervous, anxious, or on edge” and “not being able to stop or control worrying.” Response options were a 4-point Likert scale, ranging from 0 (not at all) to 4 (nearly all day). A total score was calculated from a sum of all item scores. The internal consistency for this measure was good (Cronbach’s alpha=0.861).

Aggression

Aggression was measured using the 12-item Aggression Experience Sampler (Aggression-ES; Borah et al., 2021) which assesses physical, indirect, reactive, and proactive aggression. Questions were used to assess aggression on the day prior, with items including statements like, yesterday I “lost my temper” or “physically attacked someone.” Response options were a 5-point Likert scale, ranging from 0 (not at all true) to 4 (extremely true). A total score was calculated from a sum of all item scores. The internal consistency for this measure was good (Cronbach’s alpha=0.873).

Substance Use

Substance use was assessed using 3 questions regarding whether or not participants used cannabis, alcohol, and/or tobacco on the day prior (yes/no).

Data Analysis

Preliminary analyses examined scale reliability, missing data, and descriptive statistics. There was no missing data on baseline measures. There was a total of 26 missed items (out of 18,790 total items) in completed daily diaries, spread across participants and across time-points. Further, there were 84 fully missing diary occasions (out of 672). Person-mean imputation (MI) was used to replace partially missing daily diary data. Fully missing diary occasions were accounted for with maximum likelihood (ML) estimation. A combination of MI and ML procedures for missingness in intensive longitudinal studies has been recommended by researchers, particularly since ML methods do not accurately account for partial missingness (Nooraee et al., 2018). Statistical power was determined utilizing simulation-based guidelines for multilevel models that account for both level 1 (within-person) and level 2 (between-person) sample sizes (Arend &Schäfer, 2019). The sample size in the current study of 48 individuals (level 2), each providing up to 14 daily diaries (level 1), may have provided adequate power to detect medium to large effects within the current models based on these guidelines.

To examine the impact of racial media microaggressions on outcomes of interest, multilevel models (MLM) were examined using SPSS version 29. Models were estimated using restricted maximum likelihood (REML), the default estimation method in SPSS MIXED command, which was utilized for these analyses. For continuous outcomes (depression, anxiety, and aggression), two-level (days within-persons) linear multilevel models were run, examining the concurrent and lagged-day relationships between daily experiences of racial media microaggressions and outcomes. For substance use, a two-level (days within-persons) logistic modeling was used to examine the concurrent and lagged-day relationship between microaggressions and substance use (no use versus use).

For all models, daily racial media microaggressions were person-mean centered and individuals’ mean level of microaggressions were grand-mean centered; these variables were simultaneously entered into the models. This centering technique partitions variance in the outcome variable into within- and between-person components, allowing examination of whether the likelihood of each outcome changes based on average microaggressions during the protocol and/or daily fluctuations in microaggressions (Curran & Bauer, 2011). No covariates, at either the within- or between-person level, were included in the models.

Results

The final sample included 48 participants who were mostly girls (79.17%) with a smaller minority of individuals identifying as boys (20.83%). For the current study, gender was examined as a binary category given that all participants indicated identifying with one of these two categories (boy/girl). However, it is important to note that some individuals also identified with additional gender categories, including non-binary and/or other gender (n=3, 6.25%). There was some diversity in the highest level of reported parent education (high school or less=6.25%, some college=25.00%, 4-year college degree=37.50%, advanced college degree=31.25%). The average age of participants was 17.13 years (SD=1.86). See Table 1 for sample demographics.

Table 1.

Sample Demographics

n %
Gender
 Boy 10 20.83
 Girl 38 79.17
 Non-binary or Other* 3 6.25
Highest Level of Parent Education
 High School or Less 3 6.25
 Some College 12 25.00
 4-year College Degree 18 37.50
 Advanced College Degree 15 31.25
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Note:

*

All individuals who identified as non-binary or other also identified as either boy or girl

In total, participants reported 1,892 experiences of racial media microaggressions during the 14-day diary period, with an average of 3.22 reported experiences of racial media microaggressions per day across 4 daily items. Participants also had mild average daily levels of anxiety (M=3.90, SD=4.41) and depression (M=4.55, SD=5.01), with average daily scores on the aggression measure being 2.80 (SD=5.56). Participants reported use of cannabis, alcohol, and/or tobacco products in 54 diaries (9.2%), with the majority of those reports being cannabis use (reported in 33 diaries; 5.6% of all diaries), and a minority being alcohol (17 diaries; 2.9% of all diaries) and tobacco use (4 diaries, 0.7% of all diaries). Due to low endorsement of alcohol and tobacco use among participants, only the cannabis use outcome was examined in the current study models.

Mixed effects models, both within- and between-person processes, were used to estimate the associations between daily experiences of racial media microaggressions and anxiety, depression, and aggression. There was significant clustering in the data supporting the use of mixed effects models over non-nested models (anxiety: estimate=12.254, SE=2.577, Wald Z=4.754, p<0.001; depression: estimate=15.752, SE=3.310, Wald Z=4.759, p<0.001; aggression: estimate=16.225, SE=3.515, Wald Z=4.616, p<0.001). Intraclass Correlation Coefficients (ICC) for each model also supported mixed-effects modeling, indicating that 34% of the variance in anxiety, 33% of the variance in depression, and 46% of the variance in aggression was explained at the within-person level.

Results of concurrent analysis indicated that neither within- (estimate=0.605, SE=0.602, t=1.005, p=0.320) or between-person (estimate=−0.993, SE=0.588, t=−1.688, p=0.098) effects of racial media microaggressions on anxiety symptoms were statistically significant. Results of lagged-day analyses similarly indicated that racial media microaggressions did not have a significant impact on next-day anxiety symptoms (within-person: estimate=0.304, SE=0.224, t=1.360, p=0.174; between-person: estimate=−0.282, SE=0.144, t=−1.963, p=0.050).

For depression outcomes, results also indicated that neither the concurrent within- (estimate=0.999, SE=0.686, t=1.457, p=0.151) or between-person (estimate=−1.148, SE=0.670, t=−1.712, p=0.093) effects of racial media microaggressions on depression symptoms were statistically significant. Results of lagged-day analyses similarly indicated that racial media microaggressions did not have a significant impact on next-day depression symptoms (within-person: estimate=−0.027, SE=0.249, t=−0.107, p=0.914; between-person: estimate=−0.223, SE=0.160, t=−1.390, p=0.165).

For aggression outcomes, results indicated that neither the concurrent within- (estimate=0.903, SE=0.711, t=1.270, p=0.210) or between-person (estimate=−1.323, SE=0.689, t=−1.920, p=0.061) effects of racial media microaggressions were statistically significant. However, the next-day lagged effect of racial media microaggressions on aggression at both the within- (estimate=0.610, SE=0.281, t=2.170, p=0.030) and between-person (estimate=−0.364, SE=0.182, t=−2.004, p=0.046) levels were statistically significant. See Table 2 for complete results for concurrent and lagged effects of racial media microaggressions on anxiety, depression, and aggression.

Table 2.

Concurrent and Lagged Effects of Racial Media Microaggressions on Anxiety, Depression, and Aggression

Estimate SE t p
Anxiety
Concurrent
 Within-person 0.605 0.602 1.005 0.320
 Between-person −0.993 0.588 −1.688 0.098
Lagged
 Within-person 0.304 0.224 1.360 0.174
 Between-person −0.282 0.144 −1.963 0.050
Depression
Concurrent
 Within-person 0.999 0.686 1.457 0.151
 Between-person −1.148 0.670 −1.712 0.093
Lagged
 Within-person −0.027 0.249 −0.107 0.914
 Between-person −0.223 0.160 −1.390 0.165
Aggression
Concurrent
 Within-person 0.903 0.711 1.270 0.210
 Between-person −1.323 0.689 −1.920 0.061
Lagged
 Within-person 0.610 0.281 2.170 0.030
 Between-person −0.364 0.182 −2.004 0.046
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Note: Boldface indicates statistical significance (p<0.05).

Mixed-effects (i.e., multilevel) binomial logistic models specifying both within- and between-person processes were used to examine the associations between daily experiences of racial media microaggressions and cannabis use (0=no use, 1=use). There was significant clustering in the data supporting the use of mixed effects models over non-nested models (cannabis: estimate=3.163, SE=1.909, Wald Z=3.163, p=0.002). Intraclass Correlation Coefficients (ICC) for the model also supported mixed-effects modeling, indicating that 36% of the variance in cannabis use was explained at the within-person level. Results of concurrent analyses indicated that neither within- (OR=0.519, 95%CI[0.256, 1.053], p=0.069) or between-person (OR=1.372, 95%CI[0.803, 2.345], p=0.247) effects of racial media microaggressions on cannabis use were statistically significant. Results of lagged-day analyses similarly indicated that racial media microaggressions did not have a significant impact on next-day cannabis use (within-person: OR=0.603, 95%CI[0.092, 3.955], p=0.594; between-person: OR=1.330, 95%CI[0.337, 5.246], p=0.680). See Table 3 for complete results for concurrent and lagged effects of racial media microaggressions on cannabis use.

Table 3.

Concurrent and Lagged Effects of Racial Media Microaggressions on Cannabis Use

OR 95% CI p
Concurrent
 Within-person 0.519 0.256 1.053 0.069
 Between-person 1.372 0.803 2.345 0.247
Lagged
 Within-person 0.603 0.092 3.955 0.594
 Between-person 1.330 0.337 5.246 0.680
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Discussion

This study aimed to examine the impact of daily experiences of racial media microaggressions on Black adolescent mental and behavioral health outcomes. Findings indicate non-significant concurrent and lagged-day associations between racial media microaggressions and symptoms of anxiety, depression, and cannabis use. Interestingly, the results of this study were not aligned with previous findings (e.g., Tynes, 2008, 2019) where depression and anxiety have been found to have associations with exposure to online forms of racial discrimination. Perhaps this difference can be explained by the use of tools like the Patient Health Questionnaire, which may not be sensitive to systemic and structural racism and the impact that these factors may have on the clinical presentation of mental illnesses like depression in the Black community (Jones et al., 2022). A number of studies have suggested that common assessment instruments for adolescent psychopathology may be biased or lack cultural relevance, leading to the underdiagnosis and/or misdiagnosis of minoritized populations (Liang et al., 2016).

While the concurrent effects of racial media microaggressions on aggression were non-significant, the next-day lagged effects were significant. In particular, at the within-person level, when youth in this study experienced more racial media microaggressions than usual for themselves on a given day, the following day they had greater aggression. Findings at this level may highlight the individual and subjective differences in the experience of racial media microaggressions and the amount of stress that an adolescent can tolerate. Whereas, at the between-person level, when youth in this study experienced more racial media microaggressions than the other youth in the study, the following day, they had lower aggression. It may be that findings at this level support the idea that youth with greater than average exposure to racial media microaggressions compared to their peers develop greater coping resources or adaptations through resilience processes acquired from day-to-day exposure to discrimination (Ong & Leger, 2022). Additionally, given that significant effects were observed at both the within- and between-person levels on the day following exposure to racial media microaggressions, findings suggest that the impact may not be immediate, reflecting the time needed to cognitively or emotionally process microaggressive events.

It is important to highlight that aggression is a social determinant of health for adolescents of color, affecting social interactions, educational attainment, health, and future opportunities. Black adolescents are grossly overrepresented in rates of school suspension when compared to their White peers for only minor infractions (Del Toro & Wang, 2022). Moreover, Black adolescents tend to have harsher punishments and reduced opportunities (Vannest et al., 2023), directly impacting their involvement with the criminal legal system (e.g., Annamma, 2015). Thus, it is critical to understand the nuanced relationship between factors like racial media microaggressions and aggression among Black youth as an initial step in determining how to approach intervention.

Limitations

This study was conducted within a single metropolitan area in the Midwestern United States, limiting the generalizability of the findings to Black youth in other regions or communities. Although the sample size was sufficient to detect statistically significant effects, there may have been limited power to detect effects, particularly those of small magnitude. A larger and more diverse sample would enhance the generalizability of the results and facilitate a more comprehensive examination of person and contextual factors that may influence both exposure to and the effects of racial media microaggressions on Black adolescents. Future research should investigate variables such as geographic region, household income, family and community support, intersectionality of identity (e.g., gender, sexual orientation, disability), global crises, and socio-political climate.

Additionally, this study focused solely on exposure to media microaggressions; however, Black youth may also experience positive identity-affirming messaging via the media (e.g., Rogers et al., 2021). Further, as media and technology rapidly evolve, updated measurement tools may provide more relevant and reliable data. The REMS-Checklist Racial Media Microaggressions subscale asks questions about representations of Black people through magazines, television, books, and movies. Future studies should consider exposure to racial microaggressions in other digital/social media contexts. This work was also reliant on self-report measures. While it is important to understand youth perspectives on their own experiences, self-reporting may result in limitations including potential biases or subjectivity in participants’ responses. Furthermore, psychometric properties were not reassessed following the modifications made to the measures for the current study, posing a potential limitation. Future studies should consider the development and validation of culturally-sensitive tools to measure daily mental and behavioral health outcomes.

While this study utilized a 14-day daily diary methodology, a longer-term longitudinal design with follow-up data is recommended to better assess the sustained impact of racial media microaggressions. Finally, future research may consider the impact of racial microaggressions in specific daily contexts, such as in school, social participation, and leisure activities, to understand broader influences on adolescent well-being and occupational participation.

Implications for Occupational Therapy

More research is needed to frame racism as an occupational injustice to support theoretical and conceptual development within the profession. This involves asking critical questions and making observations that support our understanding of factors which impede occupational justice, health, and well-being for marginalized populations (Grullon, 2018). Occupational therapists should use a culturally attuned lens to guide screening/assessment, as well as interventions focused on healthy media use, media literacy, and building self-regulation and coping skills. Ethnic/racial identity has been shown to be a protective factor for Black adolescents at risk for negative psychological outcomes as a result of racial microaggressions (e.g., Clifton & Zapolski, 2023). Interventions geared at understanding and solidifying racial identity may help buffer these effects.

Conclusion

Media use is a meaningful occupation for adolescents; however, Black adolescents may be at risk for exposure to racial microaggressions through engagement in this occupation. We found that exposure to racial media microaggressions impacted Black adolescent behavioral health.

Acknowledgments

The authors acknowledge and extend their appreciation to the participants in this study.

Funding Statement

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported in part by the American Psychological Association (APA), Division 38 Graduate Student Research in General Health Psychology Award (Clifton, R. L.) and NIH/NIDA K01DA043654 (Zapolski).

Footnotes

Ethical Considerations

This study was approved by the Indiana University-Purdue University Indianapolis (IUPUI) institutional review board (#13204). The data used in this study were drawn from a larger research project, as detailed in: Clifton, R. L. (2023). Daily experiences of racial microaggressions and health outcomes among Black adolescents: A daily diary study (Doctoral dissertation). Purdue University Graduate School. https://doi.org/10.25394/PGS.23563440.v1. Additionally, a separate secondary data analysis study was published using the original data set, as detailed in: Clifton, R. L., & Zapolski, T. C. (2023). Racial identity profiles among Black adolescents: Impact on the relationship between daily racial microaggressions and health outcomes. Frontiers in Adolescent Medicine, 1, 1283373. https://doi.org/10.3389/fradm.2023.1283373. A version of this work has been presented at the Society for Research on Adolescence Annual Conference in Chicago, IL (Clifton et al., 2024) and the Pediatric Academic Societies Annual Conference in Honolulu, HI (Clifton et al., 2025).

Consent to Participate

Parents provided written informed consent for participants under the age of 18. In addition, youth provided active assent or consent, for those 18+.

Declaration of Conflicting Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article

Data Availability

The data supporting the results of this study are not publicly available due to ethical and privacy concerns and research with minors.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data supporting the results of this study are not publicly available due to ethical and privacy concerns and research with minors.

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