Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time.

PURPOSE: Community violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure. METHODS: Twenty-five Black youth (14-19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety. RESULTS: Overall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = -0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = -0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05). DISCUSSION: Experiences of racism and being in discriminatory places impacted youth's depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.

A Health Information System for Scalable and Comprehensive Assessment of Well-Being: A Multidisciplinary Team Solution.

To improve the health and well-being of the medically underserved in a free clinic in Pittsburgh, Pennsylvania, a multidisciplinary team representing several health information management and information technology (IT) professionals, including faculty, students, researchers, and clinicians, created a novel IT system called imHealthy. The imHealthy system includes four critical components: a multidomain well-being questionnaire, a mobile app for data collection and tracking, a customization of an open-source electronic health record (EHR), and a data integration and well-being evaluation program leading to recommendations for personalized interventions to caregivers serving the medically underserved. This multidisciplinary team has worked closely on this project and finished critical components of the imHealthy system. Evaluations of these components will be conducted, and factors facilitating the design and adoption of the imHealthy system will be presented. The results from this research can serve as a model for free clinics with similar needs that identified by the research team in Cleveland, Indianapolis, Minnesota, Motor City, Orange County, San Diego, and St. Louis.