The ongoing issue of youth violence (YV) and substance use (SU) disproportionately affecting young Black and African American males remains a pressing concern. Although numerous programs targeting these issues in urban areas exist, homicide continues to be the leading cause of death for young Black males aged 10 to 24. Additionally, low participation and involvement in existing prevention programs exacerbate the problem, leading to a decline of up to 60% in behavioral health service utilization rates among underserved and violent youth after they turn 17. The PI’s research identifies two key factors causing the decline in service utilization: service avoidance and experiential avoidance. Service avoidance occurs when YBM evade services or institutions with official records or police presence to avoid involvement in the criminal justice system. Experiential avoidance, on the other hand, may lead to maladaptive coping mechanisms such as retaliation and substance use. Both mechanisms provide temporary relief but have long-term consequences for YBM. However, few interventions target these avoidance mechanisms as mediators/moderators of YBM service utilization. To address this need, we developed the BrotherlyACT intervention as a culturally tailored and mindfulness-based skills-building intervention to reduce the risks and effects of co-occurring YV/SU among the YBM, ages 15-24. BrotherlyACT comprises three core components: 1) video-based psychoeducational lessons presented as ready-to-use life skills that cover a range of topics on YV/SU; 2) a safety-planning toolkit offering tools for mindfulness-based stress reduction, risk assessment, goal setting, and emotional regulation, 3) a service connection chatbot named DEVON, that utilizes natural language processing (NLP) to provide talk therapy to YBM and zip-code-based navigational support to resources within a 50-mile radius. BrotherlyACT’s educational adapts an evidence-based domestic violence curriculum, Achieving Change Through Values-Based Behaviors (ACTV), grounded in Acceptance and Commitment Therapy (ACT). ACTV has shown considerable reductions in domestic and general violence recidivism and rearrests among adult populations. Our Phase-1a study played a pivotal role in shaping BrotherlyACT, which was subsequently subjected to extensive usability testing by 15 youth and adult testers. The app scored 79/100 (A-grade, 85th percentile), reflecting exceptional usability. We will conduct a single-arm pilot and feasibility study (Phase-2a) to evaluate BrotherlyACT’s feasibility and clinical utility among 60 young Black males from high-risk, high-acute pediatric emergency and high-risk, low-acute community-based settings. Primary outcomes include measures of feasibility, which encompass intervention completion rates, recruitment and retention rates, acceptability of study processes, protocol adherence, adequacy of sample size, potential for follow-up, data quality, and suitability of outcome measures. Furthermore, we will examine pre-post-intervention changes in youth violence perpetration/victimization, psychological distress, emotional avoidance, and psychological flexibility from baseline to 8 weeks post-intervention. Results of this pioneering project will (a) contribute to YV/SU prevention by establishing an innovative care model for an underserved population with restricted access to trauma-sensitive services, (b) improve the delivery of personalized, evidence-based resources that also target cognitive (individual-level) and structural (community-level) service gaps, and (c) lay the foundation for a definitive Hybrid Type 1 randomized controlled trial.

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2024-09-02

2026-09-01