Clinical trial NCT05639426: Preventing Youth Violence Through Building Equitable Communities
Official title: Preventing Youth Violence Through Building Equitable Communities: An Evaluation of a Systemic Intervention
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: NA
Conditions: Suicide
Violence in Adolescence
Lead sponsor: University of South Alabama
Sponsor class: OTHER
Collaborators: name: National Institute on Minority Health and Health Disparities (NIMHD)
name: National Institutes of Health (NIH)
First posted: 2022-12-06
Enrollment: 1672
Sex: ALL
Minimum age (years): 10
Maximum age (years): 99
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

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.

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.

Primary outcomes:
measure: Change in youth self-reported interpersonal violence perpetration
timeFrame: 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)
measure: Change in teacher-reported youth interpersonal violence perpetration
timeFrame: 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)
measure: Change in school discipline incidents for violent behavior
timeFrame: 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)
measure: Change in youth self-reported interpersonal violence victimization
timeFrame: 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)
measure: Change in youth self-reported exposure to community violence
timeFrame: 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)
measure: Change in teacher-reported youth interpersonal violence victimization
timeFrame: 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)
measure: Change in youth self-reported suicide attempts
timeFrame: 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)
measure: Change in youth self-reported suicide capacity
timeFrame: 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)
measure: Change in youth self-reported suicide ideation
timeFrame: 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)
measure: Change in school-reported youth suicide-related incidents
timeFrame: 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)
measure: Change in youth-reported race-based discrimination experiences
timeFrame: 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)
measure: Change in youth-reported perceptions of police
timeFrame: 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)
measure: Change in inclusive pedagogy
timeFrame: 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)
measure: Change in base rates in exclusionary discipline
timeFrame: 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)
measure: Change in racial disparities in exclusionary discipline
timeFrame: 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)
Secondary outcomes:
measure: Change in youth self-reported traumatic stress symptoms
timeFrame: 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)
measure: Change in youth self-reported depressive symptoms
timeFrame: 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)
measure: Change in youth self-reported general internalizing symptoms
timeFrame: 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)
Other outcomes:
Locations:
city: Mobile
country: United States
facility: University of South Alabama
state: Alabama
Study officials:
References: