# Fostering Resilience to Race-Based Stress: A Pilot Study

> **NIH VA I21** · VA SAN DIEGO HEALTHCARE SYSTEM · 2022 · —

## Abstract

Health disparities between White and Black, Indigenous and People of Color (BIPOC) are well documented in
the United States; this phenomenon is driven in part by discrimination experiences and is an important
contributor to well-being and functioning, including among military service members and Veterans. The chronic
stress of racism has both psychological and physiological effects. Discrimination is associated with increased
psychological distress, including higher rates of PTSD among Veterans of Color (VOC), poorer health behavior
and decreased healthcare utilization. Race-based stress is also linked to increased allostatic load (AL), which
is a measurable index of wear-and-tear on the body due to chronic stress exposure that is associated with
greater disease burden and mortality. Recognizing the unmet need for interventions to help VOC process and
cope with experiences of discrimination, the Race-based Stress/Trauma and Empowerment (RBSTE)
intervention (Carlson, Endsley, Motley, Shawahin, & Williams, 2018) was developed. RBSTE is a group-based
therapy that combines cultural adaptations of established psychotherapeutic techniques with novel strategies
to foster resilience and empowerment for VOC. Initial qualitative data suggests the promise of this approach,
but no systematic data are yet available to determine whether or not RBST E is achieving its goals of
enhancing coping and restoring well-being. The proposed project is a pilot randomized controlled trial (RCT)
with multi-modal longitudinal assessment. Participants will be recruited from VA facilities and the surrounding
community. VOC who report race-based stress, with minimal exclusions, will be evaluated at baseline,
randomized in groups to one of two therapy conditions and then re-evaluated immediately after treatment. The
treatments include RBSTE and a non-specific psychotherapy control, Present Centered Therapy (PCT),
designed to control for nonspecific aspects of RBSTE, including support and participation in an all-BIPOC
group. The interventions will be delivered in 8 weekly 90-minute group sessions by a trained therapist using
videoconferencing. The aims of the project are (1) to assess the feasibility of recruiting VOC for an RCT of this
nature; (2) to examine the acceptability and appropriateness of treatment content, the feasibility of
participation, and participant’s perceptions of provider behavior and attitudes; and (3) to establish the optimal
strategy for quantifying mental and physical health outcomes for future studies. Thus, the project will set the
stage for evaluation of RBSTE’s efficacy and ultimately implementation. This critically important program of
research will provide guidance as to best practices for the management of race-based stress, with the ultimate
goal of eliminating health disparities for Veterans and the community more broadly.

## Key facts

- **NIH application ID:** 10579114
- **Project number:** 1I21RX004070-01A1
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Ariel J Lang
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10579114

## Citation

> US National Institutes of Health, RePORTER application 10579114, Fostering Resilience to Race-Based Stress: A Pilot Study (1I21RX004070-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10579114. Licensed CC0.

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