Despite overall reductions in youth violence, rates of school violence remain alarmingly high among racial and ethnic minority children compared to white children. Exposure to adverse child experiences (ACEs), which include racial discrimination, place children of color at high risk for school violence. One of the most prevalent forms of racial discrimination in schools is overly harsh disciplinary practices with students of color. Intervening on ACEs, particularly racial discrimination in school discipline, is key to preventing school violence. We propose a nested randomized waitlist control trial of Link for Equity, a culturally responsive system of support for ACE-impacted children, composed of Tier 1 universal trauma-informed care and cultural humility training and Tier 2 Psychological First Aid and racial discrimination prevention.
The aims of this study are to: 1) adapt, implement and evaluate the effect of Link for Equity on school violence disparities, 2) evaluate the effect of Link for Equity on reducing teacher-to-student racial discrimination and determine if the effects of Link for Equity on school violence are mediated through racial discrimination, and 3) explore how the effects of Link for Equity on school violence are mediated through stress and connectedness mechanisms. We have partnerships with 6 districts who demonstrate significant school violence and discipline disparities and paired them by comparable demographics, school violence, discipline disparities and geography. Both a high school and a feeder middle school from these districts will participate for a total of 12 schools. We will first adapt materials to the unique trauma experiences of each school and community. Then, we will conduct a nested randomized waitlist control trial with 12 schools. Each pair of districts will be randomized to either an immediate intervention group to receive Link for Equity or a waitlist control group to receive intervention two years later. At the school-level, during intervention years, we will enroll about 1200 students of color exposed to 4+ ACEs or who screen positive for posttraumatic stress to receive Tier 2 psychological first aid. These students will also be individually randomized to receive immediate Tier 2 intervention or to another waitlist control group to receive intervention one semester later. We will employ these procedures for two consecutive school years, which is critical for sustained impacts on our primary (i.e., school violence, racial discrimination) and secondary outcomes (i.e., mediators including stress and connectedness). Our research is highly innovative in that we will use a rigorous nested randomized design, community-engaged methods to tailor our intervention materials, and multiple sources of data to pursue our study aims. Further, we have assembled a multi-disciplinary team of experts (in childhood trauma, health equity, epidemiology, interventions and biostatistics) and community liaisons with deep ties to our schools and leadership positions in education. If Link for Equity proves to be effective, our team is poised to take actionable steps towards sustainability and statewide implementation.

Public Health Relevance

Intervening on adverse child experiences (ACEs), which include racial discrimination, is a promising approach to reducing school violence among students of color. The goal of this study is to adapt, implement and evaluate Link for Equity, a culturally responsive program of trauma-informed care for ACE-impacted children, in 12 racially/ethnically diverse middle and high schools from Minnesota. We will determine if Link for Equity can effectively prevent school violence by reducing teachers' racial discrimination, increasing teacher-student connectedness and reducing symptoms of posttraumatic stress disorder.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD013801-02
Application #
9914316
Study Section
Special Emphasis Panel (ZMD1)
Program Officer
Alvidrez, Jennifer L
Project Start
2019-04-12
Project End
2023-12-31
Budget Start
2020-01-01
Budget End
2020-12-31
Support Year
2
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455