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Improving Mental Health and School Performance in Urban Eighth Graders

Not Applicable
Completed
Conditions
Depressive Symptoms
Disruptive Behavior
Trauma, Psychological
Interventions
Behavioral: RAP Club
Behavioral: Healthy Topics
Registration Number
NCT03906682
Lead Sponsor
Johns Hopkins Bloomberg School of Public Health
Brief Summary

This study assesses: (1) the impact of the Relax, Be Aware, Do a Personal Rating (RAP) Club, a school-based prevention program for urban eighth graders, on students' emotional functioning and education outcomes; (2) potential moderators and mediators of RAP Club's effects; and (3) factors related to the implementation of RAP Club, including cost of delivery and perceptions of key stakeholders.

Detailed Description

Youth in low-income urban communities are often exposed to chronic stress and trauma, which poses risk for emotional, behavioral, and academic problems. This study will evaluate the impact of RAP Club, a trauma-informed school-based prevention program intended to promote positive emotional and academic development for eighth graders. Participants will be randomly assigned within schools to receive RAP Club or Healthy Topics, a health education active control condition.

The study will achieve the following specific aims:

1. Test whether students randomized to RAP Club have improved academic, social-emotional, and behavioral outcomes as compared to those randomized to Healthy Topics (e.g., student-reported mood and stress; teacher-rated academic performance; academic record data).

2. Explore potential moderators (e.g., baseline trauma exposure, emotional regulation) and mediators (e.g., changes in self-regulation and emotional symptoms) of RAP Club's effects.

3. Evaluate factors related to program implementation, including cost of delivering RAP Club versus Healthy Topics and perceptions of key stakeholders (teachers, group facilitators, students) regarding intervention acceptability and sustainability.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
615
Inclusion Criteria
  • Subject is attending eighth grade at a participating Baltimore City Public School
  • Subject is not in a self-contained special education classroom
  • Subject provides written parent permission and written assent
Exclusion Criteria
  • Non English-speaking

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RAP Club programRAP ClubRAP Club is a 12-session universal prevention program delivered twice per week over six weeks during the school day. The program is delivered by a trained facilitator and young adult community member.
Healthy Topics programHealthy TopicsLike RAP Club, Healthy Topics is a 12-session program delivered twice per week over six weeks during the school day. The program is delivered by a trained facilitator and young adult community member.
Primary Outcome Measures
NameTimeMethod
Academic recordsPast year

Data on school performance collected by the 8th grade teacher as part of routine school practice.

Academic Competence Evaluation Scale (ACES)Past 6 weeks

10-item teacher report of student academic functioning with 3 subscales (Engagement, Motivation, Academic Performance) that is rated on a 5-point Likert scale. Mean of items 1-9 provides the total score; subscales are calculated by taking the mean of relevant items. Higher scores indicate more academic competence.

Teacher Rating of Social Competence Scale (TRSCS)Past three weeks

31-item teacher-rated scale of student classroom behavior using a 6-point Likert scale. Means are calculated for each subscale (Aggressive Behaviors, Oppositional Behavior, Attention and Concentration, Social and Emotional Competence). Higher scores reflect a higher level of that particular construct.

Strengths and Difficulties Questionnaire (SDQ)Past 6 weeks

Made up of 5 scales (Emotional Symptoms, Conduct Problems, Hyperactivity, Peer Problems, Prosocial Behavior). Several items (7, 21, 25, 11, and 14) are reverse coded. Total difficulties score is created by summing scores from all scales except the prosocial scale. The score ranges from 0-40 and is counted as missing if one of the 4 component scores is missing.

Secondary Outcome Measures
NameTimeMethod
Child PTSD Symptom Scale Revised (CPSSR)Past 2 weeks

17-item self-report measure of trauma symptoms using a 4-point Likert scale. Items are summed to produce a total score. Higher scores indicate more trauma symptoms.

Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety SymptomsPast 7 days

4-item self-report measure of anxiety symptoms using a 5-point Likert scale. Items are summed and then converted to standardized t score. Higher scores reflect higher frequency of anxiety symptoms.

Brief CopePast 6 weeks

28-item self-report measure of coping using a 4-point Likert scale. We intend to score this measure by using factor analysis to identify sub scales. In previous research, we have identified an adaptive subscale and maladaptive sub scale using this method. Higher scores indicate greater frequency of using a particular coping method.

Youth Outcome Questionnaire Self-Report (YOQSR)Past week

64-item measure of youth psychological symptoms using a 5-point Likert scale. Items are summed to produce a total score, with higher scores indicating more psychological symptoms.

Children's Response Style Questionnaire (CRSQ)Past 6 weeks

14-item self-report measure of rumination using a 4-point Likert scale. Mean score is calculated excluding item 14. Higher scores reflect greater tendency to engage in a ruminative response style.

Children's Depression Inventory - Short Form (CDI-S)Past 2 weeks

10-item self-report measure of depressive symptoms using a 5-point Likert scale. Items are summed to create a score ranging from 0-20; cutoffs can be used to determine depression severity. Higher scores reflect greater frequency of depression symptoms.

Trial Locations

Locations (1)

Johns Hopkins Bloomberg School of Public Health

🇺🇸

Baltimore, Maryland, United States

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