Community Health Through Engagement and Environmental Renewal

NCT04362475 | Completed Results

• 1 other identifier: 300004617
• Study Type: interventional
• Target: 915
• Locations: 1 country
• Sites: 1

Brief Summary

Community Health from Engagement and Environmental Renewal (CHEER) will leverage previous Centers for Disease Control and Prevention (CDC) community engagement projects to reach and intervene on a high need population. Disadvantage and poverty have long-term and transgenerational adverse impacts on social interaction and cohesion and residents' emotional and physical health. Mothers living and raising children in these conditions face multiple stressors without the community support previous generations relied on. Decades of research on American cities have connected the social, economic, and physical characteristics of neighborhoods with a lack of social cohesion, inability to maintain shared norms of acceptable behavior,and increases in health disparities and risky behaviors. Social cohesion and collective efficacy inversely associate with depression among youth. In a parallel manner, improved parenting practices and youth behavior directly associate with neighborhood social interactions and social cohesion. While these associations are suggestive, CHEER will directly test causal hypotheses at the neighborhood and family levels in a randomized control trial, that can significantly advance the evidence base for public health interventions: Family Youth Intervention (FYI) and an Environment: Social and Physical Intervention (ESPI) to increase social interaction, social cohesion, and collective efficacy and influence wellbeing of mothers and their youth.

Conditions

Blight; Family Relations

Outcome Measures

Primary Outcomes (7)

• Problem Behaviors in Children Ages 11 to 16 Years.

  Three items asked have the child ever been suspended from school and within the past 12 months prior to the baseline survey have they smoked cigarettes or drunk alcohol. Participants choose 1 for yes and 0 for no. The range is form 0 to 3, where 3 describes a higher problematic behavior. Three questions were asked at 1-week and 6 month follow-up: have they been suspended from school, smoked cigarettes or drunk alcohol since baseline.

  Baseline, 1-week and 6-month Follow-up

• Age of Sexual Initiation

  Year of age at sex. Two variables were used to measure sexual initiation. Answer choices ranged continuously from 1 (10 years old) to 9 (18 years or older).

  Baseline

• Number of Participants Who Participates in Risky Sex

  Follow-up questions for individuals endorsing sexual initiation to assess risky sex behavior. The count was assessed on how often did the participant had sex without a condom.

  Baseline

• Project on Human Development in Chicago Neighborhoods: Community Survey- Cohesion Index Subscale

  Project on Human Development in Chicago Neighborhoods: Community Survey assesses city-level variables relating to neighborhood structure. This scale consisted of 7 items that were measured on a scale of 1 to 6. The range of scores are from 7 to 35. The mean score was analyzed where the higher the score the community interaction was the worst.

  Baseline, 12-month Follow up 1 and 18-month Follow up 2

• Number of Participants Who Like Living in Their Neighborhood

  Survey item on whether they like or dislike living their neighborhood.

  Baseline

• Project on Human Development in Chicago Neighborhoods: Community Survey- Neighborhood Perception

  Project on Human Development in Chicago Neighborhoods: Community Survey assesses city-level variables relating to neighborhood structure. Three items on a scale of 1 to 6, were used to measure how participants perceive their neighborhood. The range of the scores were from 3 to 12. The mean score was analyzed where the higher the score is a better overall perception of their neighborhood.

  Baseline, 12-month Follow up and 18-month Follow-up

• Social Contacts and Resources Scale

  Social Contacts and Resources Scale, a 5-item measure of social activities with their neighbors. Responses ranged from 1 (never) to 4 (often). a total mean score were derived where higher scores indicating greater social contact. The scores range from 5 to 20.

  Baseline, 12- month Follow up 1, and 18-month Follow up 2

Secondary Outcomes (9)

• Parent-Adolescent Communication

  Baseline, 1-week and 6-month follow up

• Parental Nurturance

  Baseline, 1-week and 6-month follow up

• Family Functioning

  Baseline, 1-week and 6-month follow up

• Coping

  Baseline, 1-week and 6-month follow up

• Perceived Depression

  Baseline, 1-week and 6-month follow up

Study Arms (4)

Family Youth Intervention (FYI)

ACTIVE COMPARATOR

The primary objective of FYI is to evaluate the effectiveness of a theory-based, peer-supported family strengthening intervention on the primary outcomes in a sample of 120 parent-child pairs living in resource-poor urban neighborhoods in Birmingham. For FYI, we will utilize community health advisors (CHAs) to implement the intervention. CHAs will be recruited from each FYI neighborhood and will be trained in research ethics. CHAs will assist and support FYI participants in mastering the sequential skills of the 12 modules designed to improve maternal, youth, and family functioning. Additionally, CHAs will provide emotional social support that is helpful, hopeful, and trustful.

Behavioral: Community Health through Engagement and Environmental Renewal (CHEER)

ESPI Environment: Social and Physical Intervention (ESPI)

ACTIVE COMPARATOR

ESPI will enroll 500 community members to examine the effect of blight elimination through lot recovery on primary outcomes of improved social interaction, social cohesion around common neighborhood norms, and collective efficacy to effect change in the neighborhoods . Neighborhood residents will select a cluster of lots (2-3) for lot recovery that are highly visible in the neighborhood (e.g. on a main thoroughfare). The community residents will lead the neighborhood projects. In some cases, neighborhood residents will personally undertake all or part of the greening projects.

Behavioral: Community Health through Engagement and Environmental Renewal (CHEER)

Wait-List Control

OTHER

The two communities will get ESPI, upon completion of the study.

Behavioral: Community Health through Engagement and Environmental Renewal (CHEER)

FYI and ESPI

ACTIVE COMPARATOR

Two of the eight neighborhoods will receive both FYI and ESPI intervention.

Behavioral: Community Health through Engagement and Environmental Renewal (CHEER)

Interventions

Community Health through Engagement and Environmental Renewal (CHEER) BEHAVIORAL

FYI and ESPI intervention activities will be implemented in the overall study, CHEER. It will also allow us to examine possible synergistic effects of both interventions when implemented in the same neighborhoods. Separate sets of participants will be selected for the FYI comparisons and for the ESPI comparisons. Because the FYI intervention focuses on mothers and their children, participants for the FYI comparisons will be selected by Respondent Driven Sampling of eligible families from the neighborhoods in all four cells. The ESPI intervention targets the whole neighborhood, and thus a random sample of neighborhood residents will be enrolled in each of the four cells. Because the primary outcomes for FYI and ESPI are connected but differ from each other, the FYI samples will be assessed for the FYI outcomes in all four cells and the ESPI samples will be assessed for the ESPI outcomes in all four cells.

Also known as: Family-Youth Intervention (FYI), ESPI Environment: Social and Physical Intervention (ESPI)

ESPI Environment: Social and Physical Intervention (ESPI); FYI and ESPI; Family Youth Intervention (FYI); Wait-List Control

Eligibility Criteria

• Age: 11 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• For FYI, parents who reside in the FYI intervention neighborhood (North Titusville, South Titusville, Rising -West Princeton, and Belview Heights) and have a child age 11-16 years.
• For ESPI, residents who live in the ESPI intervention neighborhoods (North Titusville, South Titusville, Druid Hills, and Fountain Heights).

You may not qualify if:

• For FYI, does not met the above requirements and did not consent to participate.
• For ESPI, not residing in one of the above neighborhoods and did not consent to participate.

Sponsors & Collaborators

• University of Alabama at Birmingham: lead
• Centers for Disease Control and Prevention: collaborator

Study Sites (1)

UAB Center for the Study of Community Health

Birmingham, Alabama, 35233, United States

Location

Related Publications (5)

• Collins WJ, Wanamaker MH. Up from slavery? Black intergenerational economic mobility since 1880.

  BACKGROUND

• National Bureau of Economic Research Working Paper 23395 http://www.nber.org/papers/w23395 (accessed 2018 Jan 27).

  BACKGROUND

• Shaw CR, McKay HD. Juvenile delinquency and urban areas. Chicago: University of Chicago Press; 1943.

  BACKGROUND

• Aneshensel CS, Sucoff CA. The neighborhood context of adolescent mental health. J Health Soc Behav. 1996 Dec;37(4):293-310.

  PMID: 8997886 BACKGROUND

• Wilson, WJ. The truly disadvantaged. the inner city underclass and public policy. Chicago: University of Chicago Press; 1987.

  BACKGROUND

Results Point of Contact

• Title: Jeffery Walker
• Organization: UAB

jeffw@uab.edu

(205) 975-5701

Study Officials

• Jeff T Walker, PhD

  University of Alabama at Birmingham

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Hypotheses will be tested in a 2 X 2 design that includes the independent and combined effects of two interventions targeting the individual, family, and community level. Participating neighborhoods will be assigned into one of four cells: FYI alone, ESPI alone, FYI and ESPI combined, and Wait List Control.

Study Record Dates

• First Submitted: April 17, 2020
• First Posted: April 27, 2020
• Study Start: May 21, 2021
• Primary Completion: August 10, 2024
• Study Completion: September 1, 2025
• Last Updated: March 13, 2026
• Results First Posted: March 13, 2026

Record last verified: 2026-02

Locations

US (1)