Adolescents’ Experiences, Emotions, and Coping Strategies Associated With Exposure to Media-Based Vicarious Racism

Key Points Question How do adolescents respond to media-based vicarious racism, and do these responses affect adolescent emotional health and well-being? Findings This qualitative focus group–based study with 18 participants found that adolescents experienced helplessness after exposure to media-based vicarious racism and that activism was used as a positive coping strategy. Meaning The findings suggest that activism may serve as a powerful coping mechanism, potentially reducing negative emotions for adolescents exposed to media-based vicarious racism; thus, activism may have implications for improving mental health outcomes and advancing societal changes.


Introduction
2][3][4] Institutions such as health care, government, carceral systems as well as news and media are inextricable from the pervasive nature of racism.News and online platforms, such as social media, can be an important conduit for vicarious racism at the population level and may also affect health.Vicarious racism is the secondhand exposure to racism directed at another individual and occurs irrespective of the race of the unintended target; however, that unintended target or bystander must identify the event as racism. 4cently, the disproportionate murders of members of racial/ethnic minority groups by police has been a type of structural vicarious racism within the public discourse and has been associated with negative repercussions for health. 5olescents consume news of racialized violence and other racially charged events that are disseminated through traditional and online media as well as social media outlets. 6Scholarship on media-based vicarious racism exposures is emerging, and qualitative studies have begun to describe negative emotions after media-based vicarious racism exposure in adolescents. 4,7,8Given the ubiquity of these stories and ease of internet access, adolescents may have more exposure to structural racism experienced vicariously than previous contemporary periods.Thus, youth may have an increased need for positive coping mechanisms to mitigate adverse health outcomes from this exposure.
Although structural racism may require intervention at the societal level, adolescents may not have traditional access to positions of authority or policy making.However, in today's technologydriven and highly interconnected world, adolescents may seek out unique strategies to prevent and cope with racism.Given the nascent literature, studies have not yet explored how adolescents navigate media-based vicarious racism or identified the coping strategies that adolescents use following vicarious racism exposure.
Using an adolescent-centered, qualitative approach, we sought to (1) examine how adolescents respond to media-based vicarious racism and (2) to explore coping strategies adolescents use to mitigate negative emotions and structural racism, vicariously experienced in the media.We hypothesized that adolescents use a variety of coping skills after exposure to media-based vicarious racism.We also anticipated that adolescents would openly discuss the impact of vicarious racism on their health.Finally, structural racism and the resultant adverse health outcomes and disparities will require societal, institutional, and individual transformation.However, by focusing on individuallevel experiences and strategies, adolescents may be able to actively lessen the negative consequences of racism on their own health and well-being.

Study Design
This study was part of a larger qualitative study that examined 3 major thematic categories: youth experiences with media, experiences with racism online, and responses to racism. 8The current study used a phenomenological approach and reflexive thematic analysis to produce descriptive data focused on adolescent responses to racism as a critical part of elucidating how adolescents are affected by racism. 9Phenomenological research aims to describe and find commonalities in the lived experiences of a concept or of a phenomenon, in this case, racism in news and online media as experienced by adolescents. 9Focus group interviews were used to offer adolescents an opportunity to verbalize their experiences among peers, creating open-ended discussions to allow deeper understanding of their perspectives.The focus group design has been used in prior research surrounding sensitive experiences, like racism, to lessen participants' sense of discomfort or personal stigma. 8,10

Study Participants
Adolescents from all racial and ethnic backgrounds, aged 13

Data Analysis
Focus group transcripts were compared to audio recordings for accuracy and underwent reflexive thematic analysis 11

Demographic Characteristics
Four focus group sessions were conducted with a total of 18 participants.Participants had a mean (SD) age of 16.4 [1.6]; 7 (39%) self-identified as Black/African American, 8 (44%) as Hispanic/Latinx, and 3 (17%) as White adolescents; 7 (39%) were in grades 7 to 9, 8 (44%) in grades 10 to 12, and 3 (17%) at the college or university level.Self-reported demographic information was collected from all participants prior to the start of the focus group in an open-ended manner (Table 1).Age, race/ ethnicity, and gender identity were collected; however, gender identity was omitted from Table 1 to maintain anonymity for gender minority youth.

Findings
This study focuses on adolescent responses to racism, with specific attention to emotional and coping responses.Participants described coping mechanisms, such as disconnecting from media, focusing on hobbies or being creative, talking with peers, and positive thinking.However, helplessness and activism were 2 central themes that emerged from the data analysis.

Emotional Response: Helplessness Theme
Participants reported adverse emotional responses to racist events, both in-person and online.
Helplessness, as described by participants, emerged as an important negative emotion.Helplessness was a salient theme and centered on statements such as "there's nothing I can do" and included 3 subthemes (Table 2).

Subtheme 1: Racism as a Part of the World
Adolescents perceived that adults underestimated their awareness of the world around them and stated that they are not only acutely aware but witness the pervasive effects of discrimination and feel overwhelmed.Helplessness was typically the first response participants expressed regarding their emotional state after viewing racism on the news.Adolescents repeatedly stated that racism is a part of the world we live in and is unchangeable.One participant's statement that racism is "another day in the life" was met with a chorus of nodding and replies of "another day."

Subtheme 2: Dependent on the Target of Racism
Many adolescents identified circumstances in which they experienced more feelings of helplessness based on who the target of racism was.Specifically, several adolescents reported difficulty coping with racism directed at their friends, family, or themselves, whether in-person or online.There was some disagreement within focus groups, with other participants reporting feeling more helpless regarding racist events involving those they did not know.Participants endorsed feeling a greater sense of control when racism was directed at them but felt relatively powerless when racism was directed at others.During 1 focus group, when asked about racist events, participants brought up the Jason Van Dyke trial, which had reached a verdict a few months before the group met.Jason Van Dyke was a Chicago police officer sentenced to 81 months in prison after fatally shooting Black adolescent Laquan McDonald. 12Participants recalled the consequences of the court ruling and how they felt.Of note, African American/Black and Hispanic/Latinx participants still felt a sense of loss of control and helplessness even with the court ruling against Van Dyke.

Subtheme 3: Futility in Responding
The perceived ability or inability to change a situation contributed to adolescents' feelings of helplessness.These feelings, in turn, affected how participants responded to racist material: helplessness was cited as the main reason they chose not to respond at all.Adolescents across the focus groups had different explanations for their feelings of helplessness, including the events being difficult to process, the frequency of these events, and, finally, the uncertainty and anger about how to enact change.While helplessness was 1 response to vicarious racism, participants exhibited other responses, like activism.

Coping Response: Activism
Participants were asked about positive coping mechanisms to deal with racist events online, and they identified the people, including family and friends, with whom they confide, grieve, and find support.
Adolescents reported that activism helped them cope with the world around them.Activism is defined here as taking action collectively or individually to bring about meaningful change to address issues of social justice, 13 which in this case would benefit people marginalized on the basis of their race or ethnicity.Although participants were not explicitly asked about activism, this theme formed a common thread across focus groups, as participants described their responses to media-based racism, with 3 subthemes (Table 3).They described both activism at an individual level (ie, online) and as part of a group.

Subtheme 1: Activism as Altruism
Participants spoke about altruism and wishing to engage in action or activism that helped others, which emerged as a subtheme.Adolescents wished to bring about change to improve their futures and verbalized the importance of reaching out to lift up their peers.Adolescents stated that while they could not always make vast changes to systems, helping peers through activism helped them as well.original person who posted a story (the poster) if they wished to discuss content they found racist.
While a few participants reported that they had made a point to publicly address an original poster, this was rare because adolescents preferred not to engage in so-called comment wars and further perpetuate their feelings of helplessness or futility.When they did publicly address the poster, usually they would do so when the event either directly involved themselves or their friends.Participants discussed a certain tipping point, where such content needed to be addressed, and they placed emphasis on how to address these individuals.

Subtheme 3: Collective Activism
Although discussed less often, in-person activism was another tool adolescents reported using to exercise their demands for change, including group participation through school or community programs.Participants specifically discussed youth groups that they belonged to, where they could discuss topics like improving school environments for students of color (eg, Asian and Black students).Adolescents discussed issues they hoped to bring to the attention of school administration to achieve a better school environment and effectively promote change.Also, participants discussed affecting change within their own communities in Chicago.They considered the utility of getting involved in what was going on around them, either through doing the work themselves or by helping organizations that engaged in work they supported.Overall, adolescents vocalized their desire to channel their negative emotions into positive action, but they also recognized the importance of grieving and feeling pain caused by racist events.Participants reflected on how these events can actually bring them closer together as a community to continue to persevere.
Finally, participants did not identify a universal reason for engaging in activism.A participant's tipping point into activism was guided by the context of the situation as well as the accessibility and ease of the action and weighed against the benefits and drawbacks of action.Furthermore, while participants discussed the negative emotions and coping strategies used, they had more difficulty drawing firm connections to other aspects of health or health behaviors (eg, exercise, diet, taking medications)."I feel like if we have the right coping mechanisms and like the right ways to deal with it then we can use those negative emotions for like good, you know because then we can be more passionate and like change our actions to spread … loving awareness for like these kinds of things." "Like I might repost something that I feel passionate about but like I also try to spread things like positivity and like happiness and like I don't know because in a way it makes me feel better.But I also want other people to know that like it's not all bad.And I don't want everyone to be discouraged because then nothing will get fixed." Online activism "There was a time that somebody I know on his Instagram story, he posted like he was on a plane and I guess there was an Indian-Pakistani man and he took a picture of him and was like 'I'm scared.'I let him know that that was very ignorant, and then I posted it on my story, and made a comment about it being ignorant as well."suggest that activism may moderate negative mental health symptoms for African American and Latinx adolescents. 13,27olescents are not immune to the harms of racism and can experience racism online, whether they are the intended target or not.Adolescents have ready access to internet and, thus, exposure to media-based racism online.Exposure to vicarious racism online, regardless of the type of content or intended target, elicited helplessness and also prompted activism in many of our participants.
Investigating adolescents' exposure and response to racism online proves critical because of the negative changes in emotional state and potential adverse physical and mental health outcomes across the life course.Our participants did not directly associate exposure to media-based racism with changes in their physical health or health behaviors but discussed their emotional health.This study specifically focused on the adolescent experience to offer invaluable insights on navigating contemporary racism.The findings suggest adolescents exhibit helplessness and activism, seemingly opposite responses to vicarious racism.However, racism is a complex issue that will produce complex emotional and coping responses.Activism may provide adolescents the opportunity to process their feelings in a healthy manner.Future studies should build on these findings and, perhaps, develop and test interventions aimed at reducing feelings of helplessness and empowering adolescents affected by media-based racism to participate in antiracist activism.

Limitations
Our study should be interpreted within the context of its limitations.First, our sample was limited by the lack of sex and gender diversity.Of note, we did not report participant gender identity to maintain anonymity for gender minority youth; however, our focus groups had relatively fewer male participants.To further the field, there is a need for research that intentionally includes a genderdiverse sample to make our results more generalizable.Future research should examine the type of media-based vicarious racism content and responses to vicarious racism analyzed by demographic identities (eg, gender, race, and socioeconomic status) and the intersection of those identities (eg, intersectionality). 28ditionally, our participants may have been more aware of racism and more prone to action due to our recruitment strategy.Many adolescents in our sample were involved in youth groups in school that discussed racism and bias, which may not represent the greater Chicago adolescent population.However, we expect our population would have similar exposures to media-based vicarious racism, and given their involvement in youth groups, they may better describe some of the key aspects of activism that adolescents experience.
As with any focus group-based research, social desirability bias should be considered. 6ecifically, participants may have been less likely to state dissenting opinions.Additionally, we were unable to analyze specific media-based racist content participants consumed (eg, news articles, stories, videos, and comments) or present additional coping mechanisms, such as social support, because this was out of the study's scope.Future research should consider the use of communitybased participatory research designs, as that may inform the study design and subsequent results, given that adolescents would be able to better guide the scholarship.

Conclusions
In this qualitative study, adolescents reported experiencing helplessness as a primary emotion after exposure to media-based vicarious racism, and they endorsed activism as means to exercise their own power in the face of persistent structural racism.The summer of 2020 was characterized by a wave of racialized violence against Black individuals in the US that captured national attention.The deaths of George Floyd, Ahmaud Arbery, and Breonna Taylor were featured in the news, in part due to sustained and widespread protests and public outrage.National news coverage revealed not only the problematic and systemic role of racism in the lives of individuals from racial/ethnic minority groups but also illustrated that activism is a powerful response to that racism.adolescents who chose to participate in activism may be able to reduce their own negative emotions, support the emotional and mental health needs of others, and create the public will needed for policy change.
using the qualitative coding software Dedoose version 8.0.35.Three of us (A.C., P.O.E., and N.H.G.) and an additional researcher independently reviewed transcripts from each focus group, highlighting significant statements and identifying emergent codes.Through iterative review and triangulation among team members, codes were clustered or organized into themes and subthemes.Data analysis progressed in tandem with focus group interviews to assess for data saturation, and no new major themes had emerged at the time of the final session.Once finalized, themes were compared against the original transcripts, and select subthemes were further analyzed to understand the circumstances in which they occurred-ie, participants' experiences of racism online.The study authors also considered their own positionality with respect to this topic, and the first author's perspective is detailed in the eAppendix in the Supplement.

Subtheme 2 :
Online Activism Many participants' examples of activism involved action online, such as reposting on social media, given the pervasive role of the internet in their lives and interactions as well as the study's explicit emphasis on racism online.Participants discussed factors that informed their decision to comment on or share stories on social media.Many adolescents reported choosing to share stories with their friends for private discussion, either through direct message (DM) functions within social media platforms or personal text messages.Fewer instances were described in which they sent DMs to the JAMA Network Open | Public Health Emotions and Coping Strategies Associated With Exposure to Media-Based Vicarious Racism JAMA Network Open.2021;4(6):e2113522.doi:10.1001/jamanetworkopen.2021.13522(Reprinted) June 15, 2021 5/11 Downloaded From: https://jamanetwork.com/ on 09/18/2023

Table 1 .
to 19 years at the time of enrollment, and able to read and communicate proficiently in English were eligible to participate in this study.A Participants used code names to ensure privacy.Research team facilitators posed open-ended questions to the whole group, provided clarifications as necessary, and encouraged each participant to respond to each question but also gave the option to decline any question or leave the group without any penalty.Focus groups (mean [SD] duration, 51.25[28.72]minutes)were recorded digitally and transcribed using Descript transcription software (2019).

Table 1 .
Adolescent and Young Adult Participant Demographic Characteristics

Table 2 .
Helplessness Theme and Examples of the Subthemes from Adolescent and Young Adult Participants to think of a good example, but the best way I can think of is the camps that the children are put into … I don't understand our history, but I do think that as a people we are capable to be like, 'Hey, this legal system isn't working, let's just trash it and do something else,' and we don't.We just keep listening to the same White men from 200 years ago, and that was 200 years ago, and now we have f**** watches … Sorry.We have watches that talk to us, so clearly the [old] rules are changing, not applicable.They are not."Emotionsand Coping Strategies Associated With Exposure to Media-Based Vicarious Racism [After witnessing racially-charged news] "Sometimes I don't say anything.I'm just like okay.Another day in the life.""Ithinkit's become more of a norm seeing this on the news and stuff.So, when I see it, it's just like, oh this is happening again.""Ifeellike that was the spot for me to be like, 'Oh wow.This is the country we live in,' so yeah, I feel like I've gone numb to when someone will be like, 'Oh, rac[ism],' I'll just be like, 'Okay, yeah, sure.'""I'mtryingstupid.Those are the people that you just cannot change their mind because their minds don't want to be changed.""Again,Iknow that people are going to think whatever they're going to think and they're not going to change their minds until they're ready or until they decide like, 'Okay, I'm the one that is deciding it is wrong to be racist, not you telling me it's wrong.'Peopleare going to do what they're going to do, they're going to say what they're going to say."JAMA Network Open | Public Health JAMA Network Open.2021;4(6):e2113522.doi:10.1001/jamanetworkopen.2021.13522(Reprinted) June 15, 2021 4/11 Downloaded From: https://jamanetwork.com/ on 09/18/2023

Table 3 .
Activism Theme and Examples of the Subthemes from Adolescent and Young Adult Participants because a lot of people think that teenagers are not socially aware, but I think the friends that I keep around me, once we start talking about something it goes on and on and on and on.Being in programs that allow you to express yourself and actually talk to other people about how you feel on certain issues actually I feel like help everyone get a greater view and perspective on the different minds that we do have and how to accept how other people feel.""Yeah, and then sometimes my response is it's something I can do something about, like right now.'Oh, hey this thing is happening with police.No Cop Academy [a Chicago campaign to urge the city to invest money into marginalized communities instead of a new police training academy] meeting is next week.'I was like, 'I'm going.'Or I'm sending support to one of my orgs that is actively going against whatever just happened."

Adolescents are JAMA Network Open | Public Health Emotions
and Coping Strategies Associated With Exposure to Media-Based Vicarious Racism astutely aware of racism and have a nuanced view of how it affects them and others.Long-lasting societal transformation, including the elimination of health disparities, will require antiracist interventions.Multilayered approaches, including peer and family support, may be needed to buffer adolescents' exposure to racism online, specifically strategies that decrease helplessness and encourage activism safely.While the onus of addressing racism should not rest on adolescents, JAMA Network Open.2021;4(6):e2113522.doi:10.1001/jamanetworkopen.2021.13522(Reprinted) June 15, 2021 8/11 Downloaded From: https://jamanetwork.com/ on 09/18/2023