Preventing Youth Violence Through Building Equitable Communities

NCT ID: NCT05639426

Last Updated: 2024-02-06

Basic Information

• Recruitment Status: ENROLLING_BY_INVITATION
• Clinical Phase: NA
• Total Enrollment: 1672 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-09-28
• Study Completion Date: 2027-05-15

Brief Summary

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.

Detailed Description

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 communities, each comprising a police precinct and middle school. 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.

Conditions

Suicide; Violence in Adolescence

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

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.

Group Type: EXPERIMENTAL

Culturally Responsive Practices (CRP)

Intervention Type: BEHAVIORAL

The CRP component of the intervention targets pedagogy, curriculum, and potential teacher biases and discriminatory behavior. This component will consist of two intensive 4-hour workshops delivered by Morton and Billingsley in each school's first intervention year as well as one-hour annual boosters (Backpacks for Success and Culturally Relevant Pedagogy). All teachers and school administrators will participate in the workshops. The purpose of Backpacks for Success is to increase participants' awareness of structural racism, empathy for students, and motivation to change, while identifying equity targets and strategies to reach those targets. Culturally Relevant Pedagogy comprises classroom based strategies to promote equity, including use of culturally responsive curriculum, language, attitudes, and actions, with the goal of reducing interpersonal and cultural racism. Ongoing group coaching sessions will provide a space for peer support and learning around increasing CRP.

Culturally-Responsive Schoolwide Positive Behavior Interventions and Supports (C-SWPBS)

Intervention Type: BEHAVIORAL

We will implement SWPBS according to the equity-focused framework established by the Center on PBIS, with an increased emphasis on community integration. SWPBS involves creating a school team of 6-10 people, including at least one administrator, teachers, and staff members. We will include at least three community stakeholders on each C-SWPBS team to integrate the culture of the community, reducing institutional and cultural racism. Community stakeholders may be parents or other invested members of the local community not employed by the school district. The school climate specialists serve on the C-SWPBS team and provide consultation for the management of violence incidents and mental health concerns.

Interventions

Culturally Responsive Practices (CRP)

The CRP component of the intervention targets pedagogy, curriculum, and potential teacher biases and discriminatory behavior. This component will consist of two intensive 4-hour workshops delivered by Morton and Billingsley in each school's first intervention year as well as one-hour annual boosters (Backpacks for Success and Culturally Relevant Pedagogy). All teachers and school administrators will participate in the workshops. The purpose of Backpacks for Success is to increase participants' awareness of structural racism, empathy for students, and motivation to change, while identifying equity targets and strategies to reach those targets. Culturally Relevant Pedagogy comprises classroom based strategies to promote equity, including use of culturally responsive curriculum, language, attitudes, and actions, with the goal of reducing interpersonal and cultural racism. Ongoing group coaching sessions will provide a space for peer support and learning around increasing CRP.

Intervention Type: BEHAVIORAL

Culturally-Responsive Schoolwide Positive Behavior Interventions and Supports (C-SWPBS)

We will implement SWPBS according to the equity-focused framework established by the Center on PBIS, with an increased emphasis on community integration. SWPBS involves creating a school team of 6-10 people, including at least one administrator, teachers, and staff members. We will include at least three community stakeholders on each C-SWPBS team to integrate the culture of the community, reducing institutional and cultural racism. Community stakeholders may be parents or other invested members of the local community not employed by the school district. The school climate specialists serve on the C-SWPBS team and provide consultation for the management of violence incidents and mental health concerns.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• 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.

Exclusion Criteria

• Unable to give assent or consent.

• Minimum Eligible Age: 10 Years
• Maximum Eligible Age: 99 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute on Minority Health and Health Disparities (NIMHD)

NIH

Sponsor Role: collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role: collaborator

University of South Alabama

OTHER

Sponsor Role: lead

Responsible Party

Krista Mehari

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

University of South Alabama

Mobile, Alabama, United States

Countries

United States

Other Identifiers

R01MD017477

Identifier Type: NIH

Identifier Source: secondary_id

View Link

21-454

Identifier Type: -

Identifier Source: org_study_id