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Science Advances published an RCT of Working on Womanhood - group counseling for high school girls. Quick take: High-quality RCT finds no discernible effect on clinical depression, anxiety, or PTSD (primary outcomes) at 1 yr mark, but suggestive effects on a broader PTSD measure.

Program:

  • Per the study report: Working on Womanhood (WOW) "is a school-based, trauma-informed, relationship-centered, group counseling and mentoring program designed specifically by and for Black and Latinx women to disrupt the cycle of intergenerational trauma."


Study Design:

  • The study sample comprised 3,749 girls in 10 Chicago public high schools, randomly assigned to WOW vs control (usual services). 85% were Black or Hispanic; 95% were low income; nearly 30% had seen someone attacked, stabbed, shot at, hurt badly, or killed in their lifetime.

Findings:
  • Approximately 1 year after program entry, the study unfortunately found no statistically significant effects on the 3 primary, pre-specified outcomes: rates of clinical anxiety (4% T vs 4% C), clinical depression (7% T vs 9% C), or clinical PTSD (23.5% T vs 27% C).


  • On the more prevalent, exploratory outcomes of clinical or at-risk anxiety, depression, PTSD (where the study has greater statistical power), it found no significant effect on anxiety (20% T vs 20% C) or depression (19% T vs 22% C), but a significant effect on PTSD (31% T vs 39% C).


Comment:

  • Based on careful review, this was a high-quality RCT (e.g., excellent baseline balance, low to modest attrition, valid outcome measures, & pre-specified analyses). Disclosure: Arnold Ventures, my former employer, helped fund this study.


  • The study abstract unfortunately presents the results as unambiguously positive & doesn't mention (nor does the main report) that the primary hypotheses weren't supported. It highlights exploratory results that are only suggestive (could be due to chance).

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