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Examining the role of parental factors on depression among Urban African American youth living in public housing Anthony T. Estreet a,b, Dawn Thurmana, Sapphire Goodmana,b, M. Taqi Tirmazia,b, Takisha J. Cartera, and Von Nebbittc

aSchool of Social Work, Morgan State University, Baltimore, Maryland, USA; bHealth & Addiction Research Training Lab, Morgan State University, Baltimore, Maryland, USA; cGeorge Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA

ABSTRACT This study examined the potential risk and protective parental factors associated with depression among African American youth living in public housing. Utilizing a community-based participatory research approach, 239 African-American youth surveys were collected during 2013–2014 in two urban public housing developments with low socioeconomic profiles. Over half (52.3%) of the sample was in high school and female (58%). 65.3% reported living with their mother while 38% reported being employed. Bivariate analysis revealed sig- nificant correlations between depression and maternal substance abuse, paternal monitoring, parent-child relationship, and family time. Results from the regression analyses indicated that higher depression scores were significantly associated with youth who reported poor parent-child relationships, low levels of paternal super- vision and high levels of maternal drug abuse. These findings provide support for claims about the importance of parent-child relationship and paternal monitoring as a protective factor for depressive symp- toms, particularly during adolescence. Moreover, findings suggest that interventions which are targeted towards urban African American youth should address parental factors as a pathway to decrease depression among this population.

KEYWORDS Depression; risk factors; protective factors; African American; youth

Introduction

Depression among African Americans youth is a major public health concern that has been linked to substance use, heightened sex-risk and suicidal behaviors (i.e., ideation and attempts) (Breland-Noble, Burriss, & Poole, 2010; Okwumabua, Okwumabua, & Wong, 2014). Although there has been a slight increase in focus on depression among African American youth over the last decade, this group remains understudied in mental health research (Matlin, Molock, & Tebes, 2011). Evidence suggests that parents and family play a critical role in the lives of their adolescent and emerging adult children (Lindsey, Joe, & Nebbitt, 2010). It is reasonable to postulate, therefore, that parental factors are related to the emotional well-being of urban African American youth. Using a sample of 239 African American youth living in urban public housing, this paper contributes to the gap in

CONTACT Anthony T. Estreet [email protected] School of Social Work, Morgan State University, 1700 East Cold Spring Lane, Baltimore, MD 21251, USA.

JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT 2018, VOL. 28, NO. 4, 494–508 https://doi.org/10.1080/10911359.2018.1430647

© 2018 Taylor & Francis

knowledge by assessing how, or whether, parental factors are related to depressive symptoms in this vulnerable population.

Epidemiology of depression

African American youth

According to the recent findings, approximately 2.5 million U.S. youth ages 12–17 had a major depressive episode (MDE) in the previous year. Of those with MDE, approximately nine percent represented African American youth who were diagnosed during the same period (SAMHSA, 2015). Additionally, an estimated 5.8 million young adults (18–25) were diagnosed with major depressive episodes during that same period (SAMHSA, 2015). According to the National survey for drug use and health, rates of major depressive episodes have significantly increased among youth since 2005 (SAMHSA, 2016). Research has indicated that African American youth who reside in high-risk environments (increased levels of violence, substance abuse, and poverty) such as public housing settings have shown increased rates of depression (Nebbitt & Lombe, 2007; Nebbitt, Williams, Lombe, McCoy, Stephens, 2014). Comparatively, past research on African American youth and depression has resulted in mixed findings. For example, a recent study found lower rates of depression among African American young people when compared to their white counterparts (Breland et al., 2014). Conversely, a few studies have indicated that African Americans experience depression at greater rates than other ethnic groups (Lopez et al., 2017; Yip, 2015). While others found no racial difference in depression between African American and White youth (Schraedly, Gotlib, & Hayward, 1999).

Research is inconclusive on age and gender differences among youth with depression. Previous research suggests that girls are twice as likely as boys to develop depression and symptoms of depression increase with age (Maughan, Collishaw, & Stringaris, 2013). Other studies found no associations between depression and age (Bryant, 2008; Shaffer, Forehand, Kotchick, 2002) or depression and gender among a sample of urban African American youth (Nebbitt & Lombe, 2007).

Youth in urban environments

Research has also identified a myriad of social determinants of depression among African American youth (Respress, Morris, Gary, Lewin, & Francis, 2013). In addition to its impact on education, self-esteem, and anxiety, depression has been linked to substance use, sexually risky and suicidal behaviors (i.e., ideation and attempts) (Busby, Lambert, Ialongo, 2013; Jackson, Seth, Diclemente, Lin, 2015; Ofonedu, Percy, Harris-Britt, Belcher, 2012; Okwumabua, Okwumabua, Wong, 2014). Despite an increase in attention to depression among African American youth over the last decade, this group remains underrepresented in mental health research, which addresses depression and other mood disorders (Breland-Noble, Al-Mateen, Singh, 2016). Several researchers who have explored depression among African American youth sought to examine parental and familial risk and protective factors (Agerup, Lydersen, Wallander, & Sund, 2014; Boyd & Waanders, 2013; Campbell-Grossman et al., 2016; Carter, Dellucci, Turek, & Mir, 2015; Chen, 2013; Cooper, Brown, Metzger, Clinton, & Guthrie, 2013; Hurd, Stoddard, & Zimmerman, 2013). Additional studies have found a decrease in depression

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among African American youth who have an optimistic outlook during stressful situations as well as those who perceive to have a support system (Chen, 2013). Financial stressors were also positively associated with depressive symptoms (Taylor, Budescu, Gebre, & Hodzic, 2014).

African American youth are more likely to live in urban communities marked by residential segregation and concentrated poverty (U.S. Census Bureau, 2010). The chal- lenges of living in urban communities may be exacerbated for young people living in and around public housing (Nebbitt, 2015). Urban public housing developments are often epicenters of crime, violence, and alternative drug markets (Nebbitt, 2015). Furthermore, budget cuts and closure of key social services has led to a weaker form of social safety net and greater hardships among urban communities like public housing. Despite living in challenging environments and under foreboding circumstances, many youth in these communities can graduate high school, go to college and gain employment, and become healthy productive adults (Nebbitt, 2009). Indeed, it must be extremely difficult to navigate these harsh environments while simultaneously managing challenges that come with the developmental phase of adolescence.

Theorists (Nebbitt, Sanders-Phillips, & Rawlings, 2015) have suggested that minority families adapt to life in harsh environments by forming stronger familial ties and networks to protect children and youth. Parents and family may serve as primary support systems in harsh environments and especially during youth. The important roles that parents play in the lives of minority youth have been well documented. Parental factors such as parent- child relationship, parental encouragement, and parental supervision have been found to be protective factors against depressive symptoms (Henricson & Roker, 2000; Lindsey, Joe, & Nebbit, 2010; Nebbitt, Lombe, & Lindsey, 2007; Tandon & Solomon, 2010).

Parental factors and depression

Several risk and protective factors have been identified in the literature as follows: alcohol use, cannabis use, dieting, coping strategies, other illicit drug use, sleep, tobacco use and weight (Cairns, Yap, Pilkington, & Jorm, 2014). Emerging research on risk and protective factors associated with depression include dating during adolescence, media use, physical activity, relationships with positive peers, self-disclosure to parents and sports (Cairns et al., 2014). Similarly, Lindsey and colleagues suggest that parents and family play a critical role in the lives of their youth and emerging adult children (Lindsey et al., 2010). It is reasonable to postulate, therefore, that parental factors are related to the emotional well- being of urban African American youth.

Sagrestano and colleagues (2003) explain that most studies assessing depression among African American youth tend to examine the association between depression and exter- nalizing problem behaviors. However, researchers have found a positive relationship between parental factors and depression. For example, several studies have found an inverse relationship between family cohesion and warmth and depressive symptoms (Bond, Toumbourou, Thomas, Catalano, & Patton, 2005; Sagrestano et al., 2003). In addition, researchers (Lindsey et al., 2010; Matlin, Molock, & Tebes, 2011) have examined the role of parental support and depression. For example, Zimmerman and colleagues (2000) found parental support serves as a protective factor on depressive symptomology. Similarly, Holt and Espelage (2005) reported that maternal social support can moderate the relationship between victimization and depressive symptoms among African American

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males. Literature on the moderating effect of parental support on gender is inconsistent. Meadows (2007) and colleagues (Bean, Barber, & Crane 2006) report a stronger associa- tion between parental support and depression among girls rather than boys. In other studies, gender failed to moderate the effect of parental support on depression (Chester, Jones, Zalot, & Sterrett, 2007; Gutman & Eccles, 2007).

Tandon and Solomon (2009) found that living with an adult with substance abuse problems, greater exposure to violence, and delinquent peers were related to higher depressive symptoms among African American youth. However, research on maternal and paternal history of substance abuse, parent-child relationships and depression is limited. This study aims to examine the association between parental factors and depres- sion among a sample of African American living in and near the public housing development.

Purpose and hypothesis of present study

Given the current knowledge of risk and protective factors associated with depressive symptoms, this study examined paternal drug use, maternal drug use, maternal encour- agement, maternal supervision, paternal encouragement, and paternal supervision as potential parental factors associated with depressive symptoms among African American youth. Moreover, family time and parent-child relationship were examined as family factors. The aim of this study was to examine parent and family risk and protective variables for their potential association with youth depression. The hypotheses for this study were: (a) higher reporting of paternal and maternal drug use will be related to higher levels of depressive symptoms; (b) higher reporting of family time, maternal supervision and parent-child relationship will be related to lower levels of depressive symptoms, and c) higher reporting of maternal and paternal encouragement will be related to lower levels of depressive symptoms.

Methods

The current study is part of a larger cross-sectional study which utilized a Community- Based Participatory Research approach in examining the sociocultural correlates of psy- chological functioning and behavioral health of African American youth living in public housing and neighboring communities in North West Baltimore. Community representa- tives including parents and youth were primary participants selecting variables under investigation.

Participants

Participants were 239 youth selected from 2 urban public housing developments and neighboring catchment areas in Baltimore with approximately 70% of children living below the poverty line (Baltimore Neighborhood Indicators Alliance, 2014). They were in high school (52.3%), graduated high school (29.3%), and enrolled in college (14.3%). The majority of participants were female (58%) with ages ranging from 13 to 24. The sample was drawn from predominantly African American communities where 96.4% of the students enrolled in public schools were African American students and 89.5% of

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people in the community were African-Americans (Baltimore Neighborhood Indicators Alliance, 2014). The median family income was $14,105 and 67.2% of families had an annual income less than $25,000 (Baltimore Neighborhood Indicators Alliance, 2014).

Instruments

Parent/child relationship was assessed using two subscales from the National Youth Survey (NYS), (Elliot, 1987). The first subscale is composed of 4-item from the Quality of Parental Relationship Scale. The 4-item subscale assesses a youth’s perception of the quality of their relationship with her parents. Participants were asked, for example: “How satisfied are you with your relationship with your parents?” Responses range from “very dissatisfied = 1” to “very satisfied = 5.” Another item asked, for example, “How much warmth and affection do you receive from your parents?” Responses range from “very little = 1” to “a great deal = 5.” The subscale demonstrated acceptable internal consistency with the current sample (α = .79). The second subscale included 4-items that assessed the quality of time spent with parents. Participants were asked, for example, “My parents or the adult who has taken care of me or takes care of me spends time just talking with me.” Responses range from “almost never = 1 to few times a day = 4”. The subscale demonstrated acceptable internal consistency with the current sample (α = .71). Each subscale is summed so that higher scores represent a higher quality parent-child relationship.

Caregiver’s status was assessed using two items. The first item states, In my household the person I consider to be my MOTHER is: A biological mother (e.g., your natural mother who had you) = 1, my stepmother = 2, a relative (e.g., uncle, grandmother) = 4, an adult who is not related to me (e.g., foster parent, or none of the people I live with) = 4, I live alone = 4. The second item states, In my household the person I consider to be my FATHER is: My biological father (e.g., your natural father) = 1, my stepfather = 2, a relative (e.g., uncle, grandfather) = 3, an adult who is not related to me (e.g., foster parent) = 4, I live alone = 5.

Parental Alcohol and Drug Use was assessed using four items. The first two items ask, “How often does your father use the drugs?” The second item asked, “How often does your mother use drugs?” Responses range from “none of the time” to “once a month” to “once a week” to “a few times a month” to “few times a week” to “every day”. The choices of drugs were marijuana, crack/cocaine, PCP, heroin, prescription medication (i.e. Oxycontin, Vicodin, Valium, Percocet). The next two items ask “How often does your father drink alcohol?” and “How often does your mother drink alcohol?” Responses ranged from “none of the time” to “once a month” to “once a week” to “a few times a month” to “few times a week” to “every day”.

Parental supervision and support To assess parental supervision and support, youth completed the Parental Attitude Measure (PAM) (Lamborn, Mounts, Steinberg, & Dornbusch, 1991). PAM is a 12-item scale that measures two latent constructs: parental supervision (5-items) and parental encouragement (7-items). In the current study, we modified the 12-item scale to assess paternal supervision/encouragement and maternal supervision/encouragement separately. Following are examples of an item on the original parental supervision subscale: “How much does your parent or the adult who takes care of you really know who your friends

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are?” We modified this item to read: “How much does your mother or the adult female who takes care of you really know who your friends are?” and “How much does your father or the adult male who takes care of you really know who your friends are?” Items are scored on a four-point Likert scale ranging from “doesn’t know = 1” to “know exactly = 4.” The five-item subscales demonstrated acceptable paternal and maternal reliability with the current sample.

Parental encouragement An example of an item on the original parental encouragement subscale reads: “Does your father/mother, stepfather/stepmother or the adult man/woman who takes care of you push you to do your best in whatever you do?” We modified this item to read: “Does your mother, stepmother or the adult woman who takes care of you push you to do your best in whatever you do?” and “Does your father, stepfather or the adult man who takes care of you push you to do your best in whatever you do?” Items are scored on a four-point Likert scale ranging from “never = 1” to “always = 4.” The 7-item subscales demonstrated acceptable maternal and paternal reliability, respectively, with the current sample. PAM is scored by summing the items with higher values indicating higher levels of supervision and encouragement.

Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). CES-D has extensive use in assessing depression and psychia- tric epidemiology. The CES-D is a 20-item scale that assesses mood, somatic complaints, social interactions with others, and motor functioning. Responses are rated on a 4-point Likert scale ranging from “rarely or none of the time (less than one day)” = 0 to “most or all of the time (5–7 days)” = 3. The final score spans from 0 to 60, with a higher score indicating greater impairment. Respondents with a score of 16 or higher are at greater risk for clinical depression. Researchers have used various cut-off scores ranging from 12 to 24 for youth (Stockings et al., 2015). Among community samples, internal consistency estimates range from .80 to .90 (Nebbitt & Lombe, 2007; Stockings et al., 2015). The CES-D demonstrated acceptable reliability with the current youth sample (α = .82).

Procedure

Approval for this study was obtained from Morgan State University Institutional Review Board. Participants under 18 years of age were given an informed consent form that needed to be signed by parents as well as an assent form before participating in the study. Participants 18 years of age and older were allowed to sign the consent form on the day of the data collection.

The study utilized a self-administered survey technique both individually and in small groups of 5. The survey took between 30 – 45 minutes to complete. Participants were given a target gift card for participating in the study. Consent forms and assent forms were collected before data collection.

Youth were recruited in the public housing developments, outside recreation centers and social services agencies in the community. Recruitment consisted of flyers and announcements at local community centers. Members of the research team, agency liaisons, and community liaisons posted flyers in the housing developments, in commu- nity centers and in agencies around the housing developments. In addition, recruitment cards were distributed to youth living in the communities. The flyers and recruitment

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cards included a brief overview of the study, the date and location for data collection, and contact information for the PI and RA. In addition, respondent-driven sampling techni- que was utilized to recruit participants for the study.

Community engagement involved a consistent, malleable, and sensitive plan. The consistency of the plan involved a methodological process that required community ties and that reliably culminated with the successful collection of data. The malleability of the plan involved a willingness to make slight modifications to accommodate the unique characteristics of the public housing development and catchment areas. The sensitivity of the plan involved an awareness that public housing communities are not monolithic; that is, an understanding that each housing site is a unique context in its own right; and within each context, cultural norms may differ.

Using a Community Based Participatory Research (CBPR) approach allowed a greater buy-in from the community as members of the community took part in all phases of the study. Community engagement, honesty, and transparency are salient to a successful com- munity-based participatory research project. The researcher fostered genuine rapport with residents and asked for their involvement in all phases of the research project. Residents are considered primary stakeholders because their involvement is a necessary and sufficient condition to the success of CBPR within public housing developments and neighboring catchment areas. It is our position that without their support and buy-in, research in public housing and neighboring catchments areas would be extremely challenging.

Analytic strategy

In preparation for regression analysis, several inferential statistics were used to examine the bivariate relationships between parent and family factors and youth depression and to assess gender and age differences. These analyses were conducted in order to eliminate variables in the regression analyses that did not have significant correlations with youth depression.

Univariate statistics, Pearson’s correlations, independent t-tests, and one-way ANOVAs were conducted as part of our preliminary analysis. Our primary analysis included an ordinary least squared regression. Prior to conducting the analysis, data were evaluated for missing observations and normality. Missing cases and skewed variables were within the acceptable range. Descriptive statistics and graphs (e.g., measures of skewness and kurtosis, histograms, Q-Q plots, and scatterplots) were also generated and confirmed that regression assumptions (normality, linearity, and homoscedasticity) were met. In addition, variance inflation factors (VIF) and tolerance values were also generated and showed no multicolli- nearity among the variables. Stepwise linear regression was the primary analytic procedure.

Results

Sample characteristics

Participants in the study ranged in age from 13 to 24 years of age with a mean age of 18.2 years. Females composed 58% sample. Over half (52.3%) of the participants were in high school, 29.3% had graduated high school and 14.3% were enrolled in college. Almost three-fourths (74.1%), of the sample lived with their parents, 21.3% living alone, and the remaining 5% were living with relatives and/or friends. Sixty-five percent of the sample

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reported their mother lived in the household and 37.2% reported their father lived in the household. Lastly, 38.1% of the participants were employed at the time of data collection. Sample characteristics are presented in Table 1.

Pearson correlations were conducted to determine the associations between parent/ family factors and depression. The results of the Pearson correlation test are presented in Table 2. The results show a statistically significant positive correlation between depression and maternal drug use (r = .16, p < .01). Additionally, there was a statistically significant negative correlation between family time (r = -.12, p < .01), parent-child relationship (r = -.27, p < .01), paternal supervision (r = -.16, p < .05) and youth depression. Findings from the t-test reveal no differences in regard to gender and ANOVA revealed no difference in depressive symptoms among early youth (13 – 15), middle youth (16 – 19), and later youth (20 – 24).

Parental factors Participants reported an average of 15.11 (SD = 7.96) on paternal encouragement and average of 11.59 (SD = 5.25) paternal supervision. Participants reported an average of 20.50 (SD = 8.89) on maternal encouragement and an average of 14.52 (SD = 6.05) on maternal supervision. Lastly, 28.1% of the participant’s mothers had problems with

Table 1. Sample characteristics. Female (58%) Male (42%) Total

Variable n % n % N %

Early Adolescence 44 18.4 44 18.4 88 36.8 Middle Adolescence 45 18.8 37 15.5 82 34.3 Later Adolescence 49 20.5 20 8.4 69 28.9 In H.S. 77 32.2 48 20.1 125 52.3 Graduated H.S. 47 19.7 28 11.7 75 31.4 In-College 28 11.7 11 4.6 39 16.3 Living Situation Living with parents 102 42.7 86 36.0 188 78.7 Living alone 36 15.1 15 6.3 51 21.3 Caregiver Status Mother in-home 86 36.0 70 29.3 156 65.3 Father in-home 45 18.8 44 18.4 89 37.2 Employed 48 20.1 43 18.0 91 38.1

Table 2. Pearson correlations. Pearson Correlations

1 2 3 4 5 6 7 8 9

1. Paternal Drugs — 2. Maternal Drugs .539** — 3. Family Time −.106 −.180** — 4. Parent-Child Relationship −.066 −.043 .503** — 5. Maternal Encouragement .056 −.036 .207** .252** — 6. Maternal Monitoring −.030 −.001 .253** .313** .370** — 7. Paternal Encouragement −.020 −.140* .191** .137* .261** .354** — 8. Paternal Monitoring −.003 .050 .017 −.009 .072 .180** .243** — 9. Depression (CESD) .071 .161** −.121* −.266** −.020 −.102 −.103 −.155** — Means .66 .51 9.01 13.99 20.50 14.52 15.11 11.59 10.85

**. Correlation is significant at the 0.01 level (1-tailed). *. Correlation is significant at the 0.05 level (1-tailed).

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alcohol/drug use and 39.3% of the participant’s fathers had problems with alcohol/ drug use.

Family factors Participants reported an average of 13.99 (SD = 4.73) on family child relationship and an average of 9.01 (SD = 3.04) on family time.

Depressive symptoms Participants reported an average depression score of 10.85 with a standard deviation of 8.65. However, 28.9% of the participants had a score of < 16 and 17.6% had a score < 24. Using the suggested cutoff score of 24 (Nebbitt & Lombe, 2007), a little over 17% of participants reported minimal to mild symptoms. There were no statistical differences in regard to gender and age among the sample.

Predictors of depression The results of the stepwise multiple regression analysis are presented in Table 3. Of the 4 factors entered in the regression analysis, three emerged as significant predictors of levels of depression (F= 5.35, p< .005).

With a beta of -.266 (p< .01), parent-child relationship emerged as the strongest predictor of depression accounting for 7.1% of the variance in depression. The second strongest factor was paternal supervision (β= .152, p < .01) accounting for an additional 2.3% of the variance in depression. The third strongest factor was maternal drug use (β= .142, p < .05) accounting for a modest 2.0% of the variance in depression. These results indicate that presence of depressive symptoms among African American is a function of a weak parent-child relationship, paternal supervision, and history of maternal drug use. Overall, this predicted regression model explains a modest 11.4% of the total variance in levels depression. Therefore, a little over 88% of the variance is unexplained.

Discussion

Understanding the relationship between depressive symptoms and protective factors is critical for advancing our knowledge of depression among African American youth. The current study sought to examine potential risk and protective factors. Results from the study suggest depressive symptoms among African American youth are associated with higher maternal drug use, family time, paternal supervision and the parent-child relationship.

We hypothesized that higher reporting of paternal and maternal drug use will be related to higher levels of depressive symptoms. This was partially supported. Higher levels of maternal drug use were related to higher levels of depressive symptoms. This finding was consistent with a study that suggests examining the relationship between

Table 3. Stepwise regression model: depression. Model R R2 F p β t p

Parent-Child Relationship .266 .067 18.10 .000 −.266 4.900 .000 Paternal Monitoring .307 .094 6.05 .015 −.152 3.865 .000 Maternal Drug Use .338 .114 5.35 .022 .142 2.252 .000

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parental alcohol and drug use and depressive symptoms (Tandon & Solomon, 2010). Our hypothesis regarding the relationship between paternal drug use and depressive symptoms was not supported. This could be explained by the fact that over 70% of African American youth households within our study were single-parent homes in which the mother was the primary caregiver. The absence of a substance-abusing father in the home may buffer the impact of youth developing depression.

Parental factors need to be considered when exploring depressive symptomology among urban African American youth. As expected, key parental factors (child-family relationship, paternal supervision, and maternal drug abuse) were associated with depres- sion in our study. However, only partial hypothesis was found to be true in the study, as paternal and maternal encouragement, maternal supervision, and paternal drug use did not have statistically significant relationships. The findings of this study affirm previous studies with urban African American youth, which found an association between parental factors and depressive symptoms (Barton et al., 2015; Agerup et al., 2014; Garthe, Sullivan, & Kliewer, 2015).

Likewise, findings from this study were consistent with previous literature, which found a positive relationship between child family relationship and depressive symptoms (Choe, Stoddard, & Zimmerman, 2014; Hunt, Caldwell, & Assari, 2015; Taylor, Budescu, & Gebre, 2016). Findings also support previous research, which suggests that lack of parental supervision can lead to increased depressive symptomology among African-American youth (Hamza & Willoughby, 2011; Yap, Pilkington, Ryan, & Jorm, 2014). Moreover, a systemic review of the literature found a relationship between maternal drug abuse and depressive symptoms (Yap et al., 2014).

The results reported in this study offer a glimpse of the relationship among parental factors and depressive symptoms among urban African American youth living in and adjacent to public housing developments. Parent-child relationships and parental super- vision play a critical role in buffering the mental health risk of African American youth in urban communities. Findings from the study suggest that interventions addressing depres- sive symptoms among urban African American youth should be targeted to address parental factors that contribute to depression. In addition, future research studying depression among urban African Americans should include comparative samples to examine the difference regarding ethnicity. Given the importance of parents in the lives of children and youth, parental factors across ethnic backgrounds should be explored. Also, due to the complexities in the lives of urban African American youth, longitudinal studies should be conducted to explore the difference in depressive symptoms across time. Although measures to gauge youth depression have become more established over time, we need to utilize multiple measures and techniques to gauge depressive symptoms targeted to urban youth to ensure we are able to accurately capture depressive sympto- mology among this population. While the findings of this study partially supported the hypothesis between parental factors and depression, future studies should aim to include psychological functioning and behavioral health. The presence of parental substance abuse has been found to be correlated with sexual risk-taking behavior, behavioral health, and food insecurity (Lombe, Nebbitt, Chu, Saltzman, & Tirmazi, 2017; Nebbitt et al., 2015; Lombe, Nebbitt, Sinha, & Reynolds, 2016).

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Strengths and limitations

A strength of this study is its examination of key protective factors related to parents. The study’s approach to dichotomize parental factors into maternal encouragement and monitoring and paternal encouragement and monitoring is critical to examining differences in maternal and paternal factors regarding depressive symptoms among youth. Although limited in its general- izability, the information provided is useful for researchers, educators, and practitioners. Given the relatively low to moderate level of depressive symptoms, future research should aim to further explore protective factors and strategies utilized by urban African American youth in combating stress. Due to the cultural nuances of urban communities, multiple techniques and measures to gauge depressive symptoms should be incorporated.

The cross-sectional design limits this study’s ability to establish causal inferences. In addition, the accuracy of the data collected is limited due to response error as participants recall and self-report their feelings, perceptions, and behaviors. Also, numerous risk factors such as discrimination, exposure to violence, delinquent behaviors, and drug use were not included in the analysis and may influence depressive symptoms among the sample. Furthermore, findings of this study are limited in its generalizability as the data were collected in and adjacent to housing developments in North West Baltimore. Generalizing to other urban communities and African American youth should be done with caution. Lastly, using a community based participatory research approach blended with a community action research approach may be critical in developing trust, rapport, and a collective research approach to address both community and academic inquiry.

Conclusion

This study contributes to literature examining depressive symptoms among a sample of urban African American youth in and adjacent to public housing developments (Breland- Noble, Burriss & Poole, 2010; Lindsey et al., 2010; McMahon, Coker, & Parnes, 2013; Nebbitt et al., 2014; Tandon & Soloman, 2010). These findings provide support for claims about the importance of parent-child relationship and paternal monitoring as a protective factor for depressive symptoms, particularly during adolescence. While maternal drug use serves as a risk factor for depressive symptoms among this population of urban youth, paternal drug use does not. Our understanding of the samples demographic could play a tremendous role in the findings. Considering most of the study participants (65.3%) reside with their mother, it stands to reason their exposure to her substance use would have a greater impact as compared to paternal substance use. That is not to say that the role of the father is insignificant. Our research suggests that paternal monitoring has a greater effect on youth depressive symptoms than maternal monitoring. Intervention efforts aimed at parents of depressed youth may consider educating fathers on the protective role of their presence in their child’s life.

Acknowledgment

At the time of this publication, Dr. Anthony Estreet was a Scholar with the HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP), at the University of California, Los Angeles; supported through an award from the National Institute on Drug Abuse (R25 DA035692).

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Disclosure Statement

There is no financial interest held by any of the authors related to this research or publication

Funding

U.S. Department of Health and Human Services, Health and Resources Services Administration Grant # G02HP27946

ORCID

Anthony T. Estreet http://orcid.org/0000-0002-2413-6311

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