Skip to main content
OpenTrials
Completed

NCT Number: NCT04362475

Community Health Through Engagement and Environmental Renewal

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.

Completed

Looking for future studies?

Notify Me

Key information

Age range

11 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UAB Center for the Study of Community Health

Birmingham, Alabama, 35233, United States

About this study

Aim 1 Family System: To test the effect of FYI on primary outcomes of youth psychosocial behaviors and sexual risk compared to a Wait List Control.

1a. FYI will significantly improve our primary outcomes of externalizing (e.g. impulsivity, violence, theft) and internalizing (e.g. depression, withdrawal, anxiety, loneliness) behaviors and early and risky sex (i.e. sexual initiation at less than 16 years of age and sexual intercourse without a condom) (Effectiveness).

  • b. FYI will significantly lower parental stress, improve maternal emotional health, enhance parenting skills and improve youth Social and Emotional Competence (SEC) to change primary outcomes (Mediation).

Aim 2 Community System: To test the effect of ESPI on neighborhood environment compared to Wait List Control.

  • a. ESPI significantly will increase our primary outcomes of social interaction, social cohesion, collective efficacy, and shared norms compared to wait list control (Effectiveness).

2b. Engaging residents in community-designed and -led projects to develop common spaces will significantly improve neighborhood perceptions (e.g. attractiveness, safety) and provide opportunities for residents to interact to change primary outcomes (Mediation).

Aim 3 Community and Family Systems: To test the effects of combining FYI and ESPI on the same youth and neighborhood environmental outcomes as in Aims 1 and 2 compared to FYI alone, ESPI alone, and a Wait List Control.

3a. ESPI and FYI will significantly reduce primary youth and neighborhood environmental outcomes (Effectiveness).

3b. ESPI and FYI will change neighborhood environmental and family processes to change primary outcomes of adolescent SEC, external and internal behaviors, and early and risky sex (Mediation).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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).

Exclusion criteria

  • 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.

Treatment and study plan

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.

Other names: Family-Youth Intervention (FYI), ESPI Environment: Social and Physical Intervention (ESPI)

Primary outcomes

  1. Problem Behaviors in Children Ages 11 to 16 Years.

    Time frame: Baseline, 1-week and 6-month Follow-up

    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.

  2. Age of Sexual Initiation

    Time frame: Baseline

    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).

  3. Number of Participants Who Participates in Risky Sex

    Time frame: Baseline

    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.

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

    Time frame: Baseline, 12-month Follow up 1 and 18-month Follow up 2

    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.

  5. Number of Participants Who Like Living in Their Neighborhood

    Time frame: Baseline

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

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

    Time frame: Baseline, 12-month Follow up and 18-month Follow-up

    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.

  7. Social Contacts and Resources Scale

    Time frame: Baseline, 12- month Follow up 1, and 18-month Follow up 2

    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.

Secondary outcomes

  1. Parent-Adolescent Communication

    Time frame: Baseline, 1-week and 6-month follow up

    This is a 20-item scale where response choices range from 1= Strongly Disagree to 5= Strongly Agree. Items are summed to arrive at a total communication score (range 20-100), with higher scores suggesting better overall communication quality.

  2. Parental Nurturance

    Time frame: Baseline, 1-week and 6-month follow up

    Measured using using a single item, " I get the emotional help and support I need from my family." The responses to the item is on a 7-point likert scale ranging from Very Strongly Agree to Very Strongly Disagree where Very Strongly Disagree describes a less nurturing parent and Very Strongly Agree describes more nurturance the parent displays. Scores ranged from 1 to 7.

  3. Family Functioning

    Time frame: Baseline, 1-week and 6-month follow up

    American Strength Inventory was uses six categories to measure the strength of a family. Participants responded with Not true (1), Sometimes true (2) and Often true (3). The items were added for a total family strength score where a mean score was analyzed. The subscale Global Measure was used to measure family functioning. The scores range from 4 to 12, where the higher the score the higher the family functioning.

  4. Coping

    Time frame: Baseline, 1-week and 6-month follow up

    Measured using the Managing Stress and Crisis Effectively subscale of the American Family Strength Inventory assess family functioning and qualities that makes a family strong. Participants responded with Not true (1), Sometimes true (2) and Often true (3). The scores ranged from 6 to 24. The items were added for a total family strength score where a mean score was analyzed. Higher mean scores means higher coping with stress skills.

  5. Perceived Depression

    Time frame: Baseline, 1-week and 6-month follow up

    The Patient Health Questionnaire Scale (PHQ-9) is a abbreviated scale that measures self-report depressive symptoms. Respondents report on a 4-point likert scale where 0 is Not at All and 3 is Nearly Everyday. Items were added to determine the presence and severity of depressive symptoms. The range of the scores are 0 to 27. Score interpretations are 1-4 Minimal depression, 5-9 Mild depression, 10-14 Moderate depression,15-19 Moderately severe depression, and 20-27 Severe depression. A mean score was analyzed.

  6. Social Support

    Time frame: Baseline, 1-week and 6-month follow up

    Measured using items from the World Health Organization's Quality of Life Questionnaire to measure satisfaction with the level of social support they receive. The responses were on a 5-point likert scale ranging from very dissatisfied (1) to very satisfied (5). The higher the score the more scarification with their social support.

  7. The World Health Organization Quality of Life Brief Scale

    Time frame: Baseline, 1-week and 6-month follow up

    The World Health Organization Quality of Life Brief Scale measures four domains of quality of life: physical health, psychological, social relations and environment. The scores are transformed on a scale from 0 to 100 where higher score mean higher quality of life.

  8. Punitive Discipline Scale

    Time frame: Baseline, 1-week and 6-month follow up

    Punitive discipline is assessed using four items that indicate the frequency of spanking/hitting, scolding, and threatening to spank/hit or threatening to punish. Response categories included 1 = never in past 12 months; 2 = a few times; 3 = once a month or more; 4 = once a week or more; and, 5 = almost everyday. After totaling the score, the higher the score the more the parent uses punitive discipline. Scores range from 4 to 20 where the higher the score the more often the parent used punitive discipline. A mean score was analyzed.

  9. Parental Monitoring Scale

    Time frame: Baseline, 1-week and 6-month follow up

    Adolescents reported how often their parents knew where they were and what they were doing after school, on weeknights, and on weekends. All items used a 4-point scale ranging from 1 (almost never), to 2 (sometimes), to 3 (usually), to 4 (almost always). Scores ranging from 1 (low levels of parental monitoring) to 4 (high levels of parental monitoring). The range of the scores are 7-28. After totaling the score, the higher the score the higher levels of parental monitoring were present. A mean score was analyzed.

Sponsors and collaborators

Lead sponsor

University of Alabama at Birmingham

Other

Collaborators

  • Centers for Disease Control and Prevention

Registry information

Acronym: CHEER

Important dates

Study start
2021
Primary completion
2024
Study completion
2025
First posted
Apr 27, 2020
Registry last updated
Mar 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.