Preventing Youth Violence Through Building Equitable Communities: An Evaluation of a Systemic Intervention
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 1,672
- 试验地点
- 1
- 主要终点
- Change in youth self-reported exposure to community violence
研究概览
简要总结
Interpersonal or community violence is a long-standing health disparity that disproportionately affects African American youth, and suicide is disproportionately increasing among African American youth. This project evaluates the impact of a multisystemic prevention program designed to reduce health disparities in violence by promoting equity in African American youths' experiences in education systems. This intervention has the potential to reduce morbidity and mortality among African American youth, promote overall quality of life, and reduce the societal costs associated with both interpersonal violence and suicidality.
详细描述
Violence disproportionately affects African American youth. In addition to death and injury, violence exposure has significant psychological consequences, including traumatic stress symptoms and internalizing problems. Self-directed violence has shown startling and disproportionate growth among African American youth, with suicide rates nearly doubling from 2007 to 2018. Current prevention strategies have limited effectiveness, perhaps due to their failure to address the causal role of structural racism in violence. The primary aim of this proposed project is to examine the extent to which an intervention addressing structural racism in education reduces interpersonal violence and suicide among middle school-aged youth, with a focus on populations experiencing health disparities (African Americans; low-income communities). The proposed project will examine community-level changes using a multiple baseline experimental design that randomizes the start of the intervention in four middle schools. The intervention will consist of school-based intervention components including a culturally responsive, community-inclusive adaptation of a whole-school climate intervention (School-wide Positive Behavior Interventions and Supports) and culturally responsive practices training and coaching. Outcomes will be measured using archival data from the schools as well as survey data from youth and school personnel. Aim 1 is to evaluate the extent to which targeting structural and cultural racism reduces interpersonal violence among youth, as measured by individual-level and school-level data. Aim 2 is to evaluate the extent to which targeting structural and cultural racism reduces suicidality among youth, as measured by completed suicides and proximal precedents for suicide, including attempts and ideation. Aim 3 is to evaluate the extent to which targeting structural and cultural racism reduces both overall rates and disproportionality of school-based exclusionary discipline practices and increases culturally relevant pedagogy. Aim 4 is to evaluate specific intervention components by determining their effects on hypothesized mechanisms of change at the individual, teacher, and school levels. This intervention has the potential to reduce morbidity and mortality among African American youth, promote overall quality of life, and reduce the societal costs associated with both interpersonal violence and suicidality. Furthermore, effective strategies to address structural racism have the potential to facilitate groundbreaking public health prevention of health disparities.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 10 Years 至 99 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Youth will be eligible for the study if they attend a participating school, are capable of providing assent, and are able to understand spoken or written English.
- •School personnel will be eligible if they are currently employed at a participating school.
排除标准
- •Unable to give assent or consent.
研究组 & 干预措施
Strengthening Opportunities for Achievement and Resilience
Strengthening Opportunities for Achievement and Resilience (SOAR) is an intervention condition consisting of both Culturally-Responsive Schoolwide Positive Behavior Interventions and Supports (C-SWPBS) and Culturally Responsive Practices (CRP). It is a year-long, school-level intervention.
干预措施: Culturally Responsive Practices (CRP) (Behavioral)
Strengthening Opportunities for Achievement and Resilience
Strengthening Opportunities for Achievement and Resilience (SOAR) is an intervention condition consisting of both Culturally-Responsive Schoolwide Positive Behavior Interventions and Supports (C-SWPBS) and Culturally Responsive Practices (CRP). It is a year-long, school-level intervention.
干预措施: Culturally-Responsive Schoolwide Positive Behavior Interventions and Supports (C-SWPBS) (Behavioral)
结局指标
主要结局
Change in youth self-reported exposure to community violence
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess exposure to community violence, youth will complete the Survey of Children's Exposure to Violence scale. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in youth self-reported suicide capacity
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess suicide capacity, youth will complete the Suicide Capacity Scale. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in youth self-reported suicide ideation
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess suicide ideation, youth will complete the suicide subscale of the Mood and Feelings Questionnaire. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in inclusive pedagogy
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
Participating teachers in each school will provide example lesson plans on every three months. These lesson plans will be coded by trained graduate students in education using the Rubric for Culturally Responsive Lessons and Assignments, which will result in an inclusive pedagogy score. These scores will be aggregated to the community level to assess trajectories in community-level change over time as part of the multiple baseline design.
Change in school discipline incidents for violent behavior
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
We will collect archival data from the school system by participating school and quantify the number of violence-related discipline incidents (office discipline referrals, suspensions, and expulsions) that occur every three months. Violence-related discipline incidents will be aggregated to the community level to assess trajectories in community-level change over time as part of the multiple baseline design.
Change in youth self-reported interpersonal violence perpetration
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess interpersonal violence perpetration, youth will complete the Problem Behavior Frequency Scales- Adolescent Revised, Physical Aggression subscale. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in teacher-reported youth interpersonal violence perpetration
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
Teachers will complete surveys on a random sample of youth every three months over the school year for the entire project period. To assess youth interpersonal violence perpetration, teachers will complete the Problem Behavior Frequency Scales - Teacher Report, Physical Aggression subscale. Teacher report of youth will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in youth self-reported interpersonal violence victimization
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess interpersonal violence perpetration, youth will complete the Problem Behavior Frequency Scales- Adolescent Revised, Physical Victimization subscale. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in teacher-reported youth interpersonal violence victimization
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
Teachers will complete surveys on a random sample of youth every three months over the school year for the entire project period. To assess youth interpersonal violence perpetration, teachers will complete the Problem Behavior Frequency Scales - Teacher Report, Victimization subscale. Teacher report of youth will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in youth self-reported suicide attempts
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess suicide attempts and plans, youth will complete three items from the Youth Risk Behavior Surveillance Survey, which will be summed to create a suicide attempts/plans index. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in school-reported youth suicide-related incidents
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
We will collect archival data from the each participating school and quantify the number of youth suicide-related incidents based on suicide protocols administered by the school counselor every three months. Youth suicide-related incidents will be aggregated to the community level to assess trajectories in community-level change over time as part of the multiple baseline design.
Change in youth-reported race-based discrimination experiences
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess perceived racial discrimination, youth will complete the Adolescent Discrimination Distress Index. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in base rates in exclusionary discipline
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
We will collect archival data from the school system by participating school and quantify the number of exclusionary discipline incidents (a combined measure of suspensions and expulsions) that occur every three months. Exclusionary discipline incidents will be aggregated to the community level to assess trajectories in community-level change over time as part of the multiple baseline design.
Change in youth-reported perceptions of police
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
A random sample of youth will complete surveys every three months over the school year for the entire project period. To assess their perceptions of police legitimacy, youth will complete the Perceptions of Police scale. Youth self-report will be aggregated to the community level to assess trajectories of community-level change over time as part of the multiple baseline design.
Change in racial disparities in exclusionary discipline
时间窗: Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion)
We will collect archival data from the school system by participating school and quantify the number of exclusionary discipline incidents (a combined measure of suspensions and expulsions) for Black youth and White youth that occur every three months. We will use that data to create an indicator of disproportionate exclusionary discipline based on the number of exclusionary discipline events per Black youth and per White youth separately in proportion to the number of White youth and Black youth in the school. Exclusionary discipline disproportionality will be aggregated to the community level to assess trajectories in community-level change over time as part of the multiple baseline design.
次要结局
- Change in youth self-reported traumatic stress symptoms(Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion))
- Change in youth self-reported depressive symptoms(Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion))
- Change in youth self-reported general internalizing symptoms(Trajectories of change will be assessed through data collected every three months from August to May (the school year) over the course of five years (through study completion))
研究者
Krista Mehari
Assistant Professor
Vanderbilt University