The authors describe and illustrate means of engaging depressed African American adolescents in treatment. Twenty-eight youth participated in focus groups or individual interviews. Using grounded theory and transcript based analysis, they derived 5 themes describing African American adolescents’ experience of depression and suggested mechanisms for improving African American youth treatment engagement. Practitioners can educate African American youth about depression as a medical disorder, build trust, and apply innovative approaches to recognizing differential manifestations of depression in African American youth.

We present baseline data and describe the utility of a community engaged, culturally relevant approach to recruiting African American youth and families for phase I of The AAKOMA Project. The AAKOMA Project is a two phase treatment development study to improve mental health service use among depressed African American youth. We completed capacity building activities using a community engaged framework and Community Based Participatory Research (CBPR) methods. Replicating the (Alvarez et al. in West J Nurs Res 28:541–560, 2006) model of systematic community out-reach enhanced our ability to effectively recruit partners and evaluate outreach efforts as demonstrated by our Recruitment Success Factor (RSF—i.e. ‘an adjusted ratio of eligible participant yield to contacts made’). Using the chi-square goodness-of-fit statistic; we compared the RSFs of the various modes of participant study entry to determine which was most effective. Our target enrollment was 56 persons. We recruited 130 and enrolled 57. Our baseline data is drawn from a gender balanced and socioeconomically diverse sample who participated in youth focus groups and individual interviews and adult focus groups. We identified 3 study participant referral modes (self-referral, provider referral and participant-to-participant referral) with multiple sources per mode and an overall RSF of 0.41. Study findings support the effectiveness of assiduous and systematic community interaction, reflective review of recruitment efforts and the importance of disseminating information on strategic recruitment processes for engaging diverse populations in clinical research.

This manuscript focuses on qualitative data collected for AAKOMA Project, a 2-phase treatment engagement intervention trial for depressed African American adolescents and families. Data are presented from our phase I study of adult perspectives on African American adolescent depression, depression treatment, and research engagement. The research team conducted four focus groups (N = 24) and generated major themes from the data including ideas regarding the manifestations of depression in African American youth and psychosocial barriers to participation in depression research and treatment. Findings indicate that success in recruiting and retaining African American youth in depression research and treatment may include using innovative means to overcome the culturally embedded attributions of depression to non-biological causes, beliefs about the cultural insensitivity of treatments and challenges in the logistics of obtaining care. Adults report that encouraging youth and familial involvement in treatments and research should include targeted, community-partnered activities involving diverse staff in leadership roles and including community members as equal partners.

Current descriptions of coparenting (i.e., shared decision making between parents and the coordination of parenting activities; Feinberg, 2002; often are not informed by diverse cultural or family contexts, or by the perspectives of fathers. One group that has been notably absent in the coparenting literature is African American fathers. We conducted semistructured, qualita tive interviews with 30 African American fathers (28-60 years of age) of a preadolescent, biological son at-risk for depression, aggression, or both. Informed by grounded theory, we systematically identified emergent themes in the data (Strauss & Corbin. 1998). Fathers provided descriptions of both positive and negative coparenting experiences, which were nuanced at times by their residential and marital status. The findings highlight the importance of gender-based parenting differences, fathers' belief in the importance of the father-son relationship, and the significance of discipline and communication as key coparenting domains for this sample of fathers. The framework presented here represents a critical step toward the advancement of coparenting conceptualizations that incorporate diverse cultures, nontraditional family types, and fathers. This framework is a starting point from which theoretical conceptual izations can be further developed. The findings challenge negative perceptions of African American fathers and highlight modifiable factors (e.g" communication) relevant for interventions that support African American fathers, youth, and families.