Developing and Pilot Testing a Mental Health Support Intervention for Ethiopian and Eritrean Youth

PROJECT SUMMARY 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/or culturally-specific fashion. Emerging adults (ages 18-29) from Black immigrant backgrounds face multiple intersecting challenges to their

mental health, as they attempt to transition to adulthood and develop their identity, all while navigating intergenerational traumas from the immigration process as well as ongoing racism and discrimination faced as Black people in the United States. Our preliminary research has identified significant mental health disparities

impacting Ethiopian and Eritrean (collectively referred to as habesha) emerging adults in Atlanta. Despite these threats to mental health and well-being, and the growing representation of habesha 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. Our long-term goal is to improve mental health among habesha emerging adults, as a first step towards ameliorating disparities impacting Black immigrants more broadly. The objective of this R21 application is to develop and pilot test Weyera, a novel group-level

intervention facilitated by trained community health workers, with a goal to enhance resilience and improve mental health in this population. This study will pursue two specific aims: (1) To develop Weyera, a culturally- responsive mental health support intervention for habesha emerging adults; and (2) To conduct a pilot trial of

Weyera and evaluate its feasibility, acceptability, and safety. For the first aim, we will use the Intervention Mapping approach and work with our established Youth Advisory Board (comprised of habesha emerging adults) to refine an intervention outline and develop objectives and activities through a participatory, iterative

process. In the second aim, we will pilot Weyera in a randomized waitlist control trial. Our evaluation will primarily focus on feasibility, and acceptability and safety, while also exploring potential intervention impacts on hypothesized effect modifiers (resilience processes: i.e., social support, affirming ethnic identity, mental health

service utilization) and mental health outcomes (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 from this study will

provide the foundation for a larger efficacy trial of Weyera in the future. The proposed research is highly significant because of its potential to begin to address the critical gap of knowledge and intervention focused on habeshas or any Black immigrant group. Attention to understudied nuances including ethnicity, nativity and

immigration status within the Black population is critical to achieving the NIH’s overall goals of addressing the impacts of racism and discrimination on health.