Behavioral Effects of a Telehealth Family Prevention Program for Black Adolescents: 2 Year Results of a Randomized Trial.

backgroundBlack adolescents face disproportionate behavioral health and substance use risks amplified by structural racism and discrimination, yet access to culturally grounded, family-centered preventive interventions remains exceedingly rare. Telehealth may advance prevention equity by eliminating geographic and logistical access barriers.

methodsA randomized controlled trial enrolled 170 families with Black adolescents (ages 11-12) assigned to T-SAAF-a telehealth adaptation of the evidence-based Strong African American Families program-or a no-treatment control. At 2 year follow-up, 145 families (85%) completed assessments. Youth-reported conduct problems and substance use onset were analyzed using ANCOVA and binary logistic regression, adjusting for baseline scores, age, sex, time between assessments, and caregiver educational attainment.

resultsT-SAAF participants reported significantly fewer conduct problems at 2 year follow-up (M = 1.51, 95% CI [1.35, 1.67]) than controls (M = 1.77, 95% CI [1.59, 1.94]; F[1,137] = 4.49, p = 0.036, η DISCUSSION: A brief, culturally grounded telehealth family intervention reduced conduct problems among Black adolescents at a 2 year follow-up, relative to a no-treatment control. Substance use onset did not differ between conditions. These findings position digitally delivered, family-centered prevention as a promising, equity-focused strategy for extending evidence-based programming to underserved Black families. Trial Registration ClinicalTrials.gov NCT05253235; registered February 22, 2022.