preventing youth violence through building equitable communities

Conditions: Suicide; Violence in Adolescence

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.

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.

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.