PROJECT SUMMARY/ABSTRACT
This career development award will establish Dr. Ashaunta Anderson, MD, MPH, MSHS, as an independent
investigator with a focus on the development, implementation, and dissemination of evidence-based racial
socialization interventions for young African American children, using experimental and mixed-method
approaches. This K23 award will provide her with the support she needs to develop expertise in 4 areas: 1)
randomized controlled trials, 2) structural equation modeling, 3) mixed methods in dissemination and
implementation science, and 4) leadership and professional development. African American children
disproportionately experience racism, which is associated with behavioral health problems and school failure.
Behavioral health problems impede learning and are more likely to be chronic, severe, disabling, and untreated
in African Americans compared to Whites. Clinic-based interventions that boost cultural pride may improve
outcomes related to behavioral health in young African American children. However, little is known about
cultural pride interventions in this population. It is important to understand these processes in young children
because early childhood is a period during which racial bias may develop and stymie behavioral health and
learning, and cultural pride may support it. This project will recruit patients from AltaMed primary care clinics
affiliated with Children’s Hospital Los Angeles. AltaMed is the United States’ largest system of Federally
Qualified Health Centers. The project will pilot a cultural pride intervention (Cultural Pride Reinforcement for
Early School Readiness (CPR4ESR)) in young African American children using experimental and mixed
methods. CPR4ESR provides culturally themed children’s books and advice at health supervision visits of
children enrolled at ages 2-4 years. It is based on a well-established national program called Reach Out and
Read (ROR). ROR provides children’s books and book-sharing advice at health supervision visits with reports
of increased book-sharing behaviors and literacy. The specific aims of the proposed project are to: 1) assess
the feasibility and acceptability of CPR4ESR implementation among parents and providers, 2) evaluate the
capacity of CPR4ESR to improve cultural pride reinforcement and book-sharing behaviors in parents of young
African American children, and 3) evaluate the capacity of CPR4ESR to improve behavioral health and literacy
in young African American children. The interviews conducted in Aim 1 will guide refinement of the intervention
tested in Aims 2 and 3. The qualitative assessment will be complemented by quantitative trial statistics (e.g.,
recruitment rate) that inform trial feasibility and acceptability. Finally, the mechanism by which CPR4ESR
impacts the primary outcome, behavioral health, and the secondary outcome, literacy, will be evaluated by
structural equation modeling. This project will inform the development and implementation of early childhood
interventions that address the deleterious health-related effects of racism among African Americans.
