ABSTRACT. The coronavirus disease 2019 (COVID-19) has dramatically impacted the lives of adolescents, with potential negative implications for health and wellbeing across the life course. These impacts are particularly pronounced for low-income adolescents of color, who are disproportionately exposed to stresses and traumas associated with the pandemic, such as family illness, school disruption, food insecurity, and financial strain. These exposures are likely to exacerbate pre-existing inequities in mental health, putting low- income youth of color at increased risk for mental health problems. It is critical that we identify interventions and supports to improve mental health for vulnerable adolescents during and following the current crisis. To achieve that goal, this competitive revision will leverage an existing parent study (IES R305A160082 / 1RO1HD090022, PI: Mendelson), an efficacy trial to test the impact of a trauma-informed universal intervention called RAP Club on mental health outcomes for predominantly Black 8th grade students in low-income urban communities. Participants were recruited from 29 urban public schools, with separate cohorts enrolled each year for four years (Cohorts 1-4). Three student and teacher assessments during 8th grade and a follow-up student assessment during 9th grade provided multi-level longitudinal data on adolescent mental health and individual, family, peer, school and neighborhood risk and protective factors for adolescent mental health. This urgent competitive revision will extend the parent trial by collecting new quantitative and qualitative data during COVID-19. The study will be conducted without any in-person contact. We will enroll students in Cohorts 2-4 (n = 500) who are now in grades 9-11. We will administer a virtual survey to evaluate participants’ mental health during COVID-19, as well as COVID-related experiences. We will also conduct qualitative phone interviews with a subset of participants and their caretakers to understand adolescents’ experiences during COVID-19 in greater depth. The study will: (1) test the impact of RAP Club on adolescents’ mental health during COVID-19, and (2) identify longitudinal multi-level risk and protective factors that predict adolescent mental health during COVID-19, controlling for intervention arm. Moderators and mediators will be evaluated for each aim. We will assess multiple domains of mental health, including emotional wellness, and will use geographic information systems (GIS) data to explore neighborhood factors. This project represents an extraordinary opportunity to assess the impact of COVID-19 on adolescent mental health and potential strategies for increasing mental wellness during COVID-19 and beyond. Few mental health intervention studies have collected such extensive multi-level data on a primarily Black, low-income urban adolescent sample at multiple time points, and none to our knowledge have assessed mental health during a pandemic. The study will substantively advance theory and science on adolescent resilience and will inform public health practice and policy regarding best practices for supporting mental health in vulnerable adolescents.

Adolescents of color in low-income urban communities are disproportionately exposed to stress and trauma during the COVID-19, exacerbating health and mental health disparities. This urgent competitive revision will build on a current intervention trial with a sample of low-income, predominantly Black urban adolescents to evaluate: 1) the long-term impact during COVID-19 of a previously delivered universal intervention to promote adolescent mental health, and 2) multi-level, longitudinal risk and protective factors that shape adolescent mental health during the pandemic. Findings will inform public health practice and policy to enhance mental health for the country’s large and growing population of vulnerable adolescents.