Background

Prior research suggests that cultural tailoring of interventions increases personal relevance and enhances behavior change among adults. Tailoring to African Americans (AA) often does not account for the heterogeneity of the population. One study that has addressed this concern found that tailoring to ethnic identity (EI) among AA adults may improve intervention impact. However, it is not known whether tailoring to EI would be beneficial among youth. In an effort to culturally tailor a healthy eating mobile intervention, we explored the EI of potential participants to determine if this could be used to tailor the graphics included in the mobile application.

Methods

Focus groups (N=6) with AA youth were conducted in three cities in Michigan: Detroit, Flint, and Benton Harbor. Each participant’s ethnic identity score (EIS) was calculated using the Multigroup Ethnic Identity Measure (MEIM) with scores ranging from 4 (high EI) to 1 (low EI). Participants were presented with images ranging from high to low Afrocentricity (depicting varying races, skin tones, and hair texture/styles), and were asked to select the ones they preferred. Descriptive statistics were used to compare image choices with average EI scores.

Results

The average EIS for all participants (N=38) was 3.0 (range: 1.67-3.5). The average EIS varied by city (Detroit 2.95; Flint 2.91; Benton Harbor 3.16). Of the 11 pictures reviewed by all groups, 2 images were preferred by those with higher EIS (images were highly Afrocentric), 3 by those with lower EIS (images were less Afrocentric) and 6 had mixed responses. To provide more nuanced tailoring for AA youth, two groups were created using the MEIM score: group A, 3.01-4 (higher EIS) and group B, 1-3 (lower EIS).

Conclusions

When working with AA youth, the Ethnic Identity Score may be a helpful means of guiding graphic cultural tailoring. However, our results suggest that cultural tailoring for youth is nuanced and future work is needed to optimize this method in pediatric interventions.