Reducing Mental Health Disparities in Black Children: Testing a Cultural Adaptation of Parent-Child Interaction Therapy

Black children experience disproportionately high rates of disruptive behavior disorders and punitive discipline but few options for well-matched care. Parent-Child Interaction Therapy (PCIT) is a well-established, evidence-based treatment for behavior disorders, but it lacks demonstrated efficacy with Black families. This study will evaluate Cultivating Optimal African American Child Health (COAACH), a culturally adapted version of PCIT that Coates developed with input from Black families and clinicians. COAACH promotes positive parent-child relationships to nurture positive development, reduce disruptive behaviors, and strengthen ethnic-racial socialization to protect against racial bias and discrimination. Coates will use a randomized-controlled trial design with 80 parent-child dyads equally assigned to receive COAACH or PCIT. To compare engagement levels, the team will collect data on attendance, compliance with assigned homework, and attrition via electronic medical records and clinicians. The team will use linear mixed-effects models to analyze data on child disruptive behaviors, parent-child relationship, ethnic-racial socialization, and racial identity from caregivers, children, and teachers at three time-points: pre-intervention, post-intervention, and six months post-intervention. Finally, the team will examine interviews with caregivers from the treatment and control groups to explore how families experience COAACH versus PCIT. Findings can offer insight into a culturally responsive intervention that could be integrated into multiple youth-serving systems to improve outcomes for Black youth.