American youth and young adults face persistent and chronic stressors, which have contributed to a mental health crisis in the United States. Four in 10 American high school students experience chronic feelings of sadness and hopelessness, 2 in 10 report suicidal ideation, and 1 in 10 attempt suicide. For adolescents and young adults, chronic stress translates to weathering, or wear and tear on the mind and body. Chronic stress in youth contributes to psychological distress, elevated allostatic load, and an elevated risk for chronic diseases and premature death. While the connection between chronic stress and health is well documented, few studies provide evidence on innovative, non-medication strategies to reduce stress and mitigate the consequences of chronic stress on psychological and physiological outcomes. Thus, there is a critical need to rigorously test interventions that prevent the negative influence of chronic stress on mental and physical health, beginning in adolescence. The specific aims of the study are to 1) Determine whether a community-engagement, peer-based behavioral intervention reduces depressive symptoms in adolescents and young adults, 2) Determine whether a community-engagement behavioral intervention lowers allostatic load scores in adolescents and young adults, and 3) Identify factors that help sustain or inhibit community-engagement and intervention effects for adolescents and young adults. To accomplish these aims, the team will conduct a phase II community-engaged, peer group-based, multi-component randomized behavioral clinical trial. We will collect psychological and physiological measures at baseline, then at 6-month intervals for 2 years post-community-engaged, skills training.

Detailed Description: The investigators will conduct a phase II group-based, multi-component, and multi-level randomized behavioral clinical trial. The investigators will recruit and enroll 300 participants aged 15-20 (N=150 intervention and N=150 control) in Chicago, Illinois. After enrollment, participants will be randomized using a block-stratified randomization technique to ensure balance regarding race, ethnicity, and gender. Once participants are recruited, the investigators will use a computer-generated random number sequence to assign participants to the intervention group (Rise Community Engagement) or control group (Adulting 101: Life Skills Training). Participants assigned to the intervention arm will participate in 5 half-day, peer-based, interactive sessions teaching community engagement principles. Participants will be assigned to the control arm and will participate in 5 half-day interactive sessions teaching life skills training. Participants in the control arm will undergo life skills training with the same number of sessions and duration as the intervention arm.

Participants in both the intervention and control arms will report depressive symptoms on a clinically relevant measure (e.g., Patient Health Questionnaire-9) at baseline and then <1-, 6-, 12-, 18-, and 24- months post-initial 5-day community engagement or life skills training. In addition to depressive symptoms, the investigators will measure other aspects of psychological distress, including anxiety and stress, as secondary outcomes. Participants in both groups will have biometric samples, like blood draws, and clinical measurements of allostatic load at baseline and then 6-,12-, and 24- months post-initial 5-day community engagement or life skills training.

The proposed project will use a cluster randomized trial, which involves complete groups of individuals randomized to conditions (i.e., intervention, control), with clustering occurring in both arms. All of our statistical analyses will appropriately model the dependency among observations, which is a hallmark of multi-level modeling.

Inclusion Criteria:

1. 15-20 years old
2. Identify as Black and/ or Hispanic/Latine
3. Speak English

Exclusion Criteria:

1. Younger than 15 years old, or older than 20 years old
2. Unable to attend the in-person sessions
3. Non-fluent English speaker
4. Do not identify as Black or Hispanic/Latine

Northwestern Univ. (NU) and Lurie Children's (LCH) are committed to the open and timely dissemination of all research outcomes through the development of repositories and databases, posting of data on open websites, presentations, and through publications as soon as is feasible after peer review. Team will assure the confidentiality of all human subjects' data and will adhere to all HIPAA rules to ensure compliance with human subject confidentiality requirements. Collaborators will ensure that any data obtained as a part of the awarded grant will be made available to collaborators and to the general research community through databases and public repositories and by publishing in printed or electronic form as soon as practically possible after the data have been obtained and peer-reviewed. Team agrees to publish all data derived from this award in a timely fashion and to make those data freely available via

Research data will be made publicly available through posting on open websites, presentations, and peer-reviewed publications (in some cases after an embargo period not to exceed one year). Inventions appropriate for commercialization will be protected via intellectual property (IP) filings, commercialized, and provided to society as products or services by or through the Innovation and New Ventures Office, NU's technology transfer office. Innovation and New Ventures Office manages NU's invention disclosure, assessment, patenting, and marketing processes. NU is committed to the free exchange of data and resources and for the rapid commercialization of biomedical inventions for the benefit of the public, consistent with the terms of the Bayh-Dole Act. NU's commercialization practices to date have maximized the public benefit of inventions arising from federal funding by providing useful, commercially relevant, and available products and services.

Data and resource sharing is an essential to the study activities. The team will share the data and resources generated by this project by making our findings, intervention materials and protocols (e.g., training materials, manuals, etc.), available to the following communities:

1. Scientists interested in developing, implementing, and testing activism as an approach to reduce the health risks associated with structural racism, particularly among adolescent and young adult populations. Data and resource sharing with this community will encourage dialogue about the nuances of activism as a youth health intervention, implementation, and evaluation research in youthfocused community settings.
2. Practitioners, clinicians, youth educators, administrators, and other decision-makers, so our findings may be used to inform youth civic education and advocacy programming;
3. The community at large, so adolescents, young adults, and their caregivers and educators can use our findings