CHEER: Community Health through Engagement and Environmental Renewal (2019-2024)

The CHEER project originates from meetings with city residents who defined their key community needs as blight and children’s future success. CHEER builds on our and other observational studies demonstrating that youth risk behaviors are associated with family and neighborhood adversities. Multiple studies have built a solid research base to inform our understanding of the many upstream social determinants that contribute to poor health and increased health disparities. While we know that altering the future trajectories of vulnerable urban youth will require multilevel efforts that influence both family and community systems, efforts to do so with interventions of sufficient intensity to bring measured lasting effects have not been conducted or disseminated. Further advancements in community health research will require rigorous studies that test causal hypotheses in a randomized controlled trial that evaluates the independent and combined effects of a Family System intervention and a Community System intervention compared to a Wait List Control condition.

In this 5-year project we will employ a 2 x 2 design and recruit 780 parent–youth pairs to examine (and aim to improve) adversities at the family (e.g. maternal stress, depression, and parenting practices) and community (e.g. neighborhood disadvantage and decay, and social isolation) levels, testing their independent and combined effects, including possible synergies of these interventions, on our primary outcomes of improved social norms, social cohesion, and collective efficacy and reduced early and risky sex and externalizing and internalizing behaviors among youth.

The Family System Intervention will test an individually tailored (using baseline skill levels to determine dose), personally paced intervention facilitated by Community Health Advisors and delivered via e-health or print media. Goals are to enhance maternal coping and emotional regulation to positively impact parenting practices and parent–child communication and to reduce family conflict.

The Community System Intervention will offer microgrants for greening vacant, unkempt lots through community driven projects (e.g. gardens, picnic, and playground areas). Goals are to encourage social interactions to enhance social cohesion and collective efficacy and to increase shared norms. These neighborhood projects will be led by volunteer community leaders and organizers.

CHEER will inform the science on direct effects of each intervention as well as their underlying mechanisms. The CHEER effective interventions will be translated with deliverables that ensure sustainability and scalability. With the overall goal to improve quality of life and reduce health disparities, CHEER will contribute to community engaged research and serve as a blueprint for the future of evidence-based public health that can be translated and ensure sustainability and scalability.