Outcomes of the linking exercise for advancing daily stress (LEADS) management and resilience randomized pilot trial in African American adolescents and families

Background Previous research has examined the deleterious impact of racial stress on African Americans' mental and physical health; however, few interventions have focused on utilizing culturally salient protective factors to buffer the effect of racial stress on physical health outcomes.Purpose This pilot feasibility trial assessed the preliminary impact of Linking Exercise for Advancing Daily Stress (LEADS) Management and Resilience, a cultural and family-based resilience intervention aiming to increase physical activity and improve coping in overweight African American adolescents (N = 23 adolescent-caregiver dyads; adolescent Mage 14.0 +/- 2.2; MBMI percentile 97.8; 61.9% female; Parents Mage 46.4 +/- 8.8; MBMI 41.2 +/- 7.6; 100.00% female).Methods The 10-week feasibility trial tested an online family-based group resilience and health promotion program compared to an online health education only program.Results Process evaluation demonstrated high feasibility and acceptability of both group programs. As hypothesized, among adolescents, the treatment means reflect an average increase of 4.31 min/day of moderate-to-vigorous physical activity in the intervention group compared to an average decrease of 7.84 min/day of moderate-to-vigorous physical activity in the health education group. For light physical activity, treatment means reflect an average increase of 11.08 min/day in the intervention group and an average decrease of 2.56 min/day in the health education group. Also, the intervention adolescents and parents had greater engagement in adaptive coping skills (active coping, religion to cope, cognitive reframing) from baseline to post-treatment than the health education group, and greater reductions in maladaptive, and passive coping skills (self-distraction) than the health education group.Conclusions This pilot feasibility trial demonstrates the acceptabity and feasibiity of integrating culturally sensitive strength-based interventions for African American families to promote health promotion behaviors and coping. This study assessed the preliminary impact of Linking Exercise for Advancing Daily Stress (LEADS) Management and Resilience program, a cultural and family-based resilience intervention aiming to increase physical activity and improve coping in overweight African American adolescents. The 10-week feasibility study tested an online family-based group resilience and health promotion program compared to an online health education only program. Participants reported high acceptability such as enjoying, comprehending, and learning from the program content. Among adolescents in the family-based resilience and health promotion group, moderate-to-vigorouse physical activity increased on average by 4.31 min/day. For adolescents in the health education only comparison program moderate-to-vigorous physical activity decreased on average by 7.84 min/day. For light physical activity, adolescents in the family-based resilence programs showed an average increase of 11.08 min/day, while those in the health education comparison group showed a decrease of 2.56 min/day. Both adolescents and parents in the family-based resilence program had greater engagement in adaptive coping skills (active coping, religion to cope, cognitive reframing) from participating as compared to the health education group, and greater reductions in maladaptive, and passive coping skills (self-distraction) than the health education group. This study shows prelimininary support for integrating culturally sensitive strength-based intervention components for African American families to promote physical activity and coping.