Evaluation of Link for Equity (School Staff Population)

NCT04026477 | Completed

• 2 other identifiers: STUDY000070521R01MD013801-01
• Study Type: interventional
• Target: 1,612
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators propose to develop and evaluate Link for Equity, a trauma-informed system of care. Link, a system of support for ACE-affected children, is composed of universal school Trauma-Informed Care. Preventing Racism through Awareness and Action (PRAA) is a perspective-taking racism/discrimination prevention intervention for school staff that increases awareness of racism and how it impacts students and promotes empathy for students of color. Link for Equity will be translated to be culturally responsive for 12 secondary public schools in metropolitan and rural Minnesota with substantial racial/ethnic minority students and racial/ethnic disparities in school discipline and violence. Using a nested, rigorous, and ethically acceptable randomized waitlist control design, the investigators will implement and evaluate Link for Equity sequentially for two years in each school. The overall goal is to evaluate if Link for Equity can reduce school violence disparities.

Conditions

Behavior

Outcome Measures

Primary Outcomes (4)

• Change in Color Blind Racial Attitudes Scale (CoBRAS) Score

  This is a 20-item scale that measures denial of racism and white privilege and rejection of the belief that action is needed to eradicate the negative consequences of racism. Items are scored on a scale from 1 (strongly disagree) to 6 (strongly agree). Total scores are calculated by summing scores from all 20 items. Possible total scores range from 20-120 with higher scores indicating a stronger attitude of color-blindness.

  baseline and 2 years

• Change in Acceptability of Racial Microaggressions Scale (ARMS) Score

  Attitudes towards racial microaggressions will be measured using two subscales of the Acceptability of Racial Microaggressions Scale (ARMS): Color Evasion and Power Evasion. The Color Evasion subscale contains 8 statements and the power evasion subscale contains 7 statements, which staff score for appropriateness on a scale of 1 to 6. The scores for the Color Evasion subscale are averaged. The resulting score ranges from 1 to 6, with a higher score indicating higher acceptability of color evasion microaggressions. Likewise, the Power Evasion subscale scores are average, with final scores ranging from 1 to 6, and higher scores indicating a higher acceptability of power evasion microaggressions.

  baseline and 2 years

• Change in Attitudes Related to Trauma-Informed Care Scale (ARTIC) Score

  Attitudes related to trauma-informed care will be measured with the Attitudes Related to Trauma-Informed Care Scale (ARTIC), developed by the Traumatic Stress Institute. The ARTIC-10 Education version is a validated measure containing 10 questions answered on a bipolar Likert scale from 1 to 7. Certain items are reversed, and the item scores are averaged. Final scores range from 1 to 7, with higher scores indicating more favorable attitudes related to trauma-informed care.

  baseline and 2 years

• Change in Scale of Ethnocultural Empathy Score

  Ethnocultural Empathy will be measured using the validated Scale of Ethnocultural Empathy. The scale contains 31 statements, rated from 1 (strongly agree that this describes me) to 6 (that strongly disagree that this describes me). Certain items are reversed, and the item scores are averaged. Final scores range from 1 to 6, with higher scores indicating higher levels of ethnocultural empathy.

  baseline and 2 years

Study Arms (2)

Immediate Universal Trauma-Informed Care and Cultural Humility Training

EXPERIMENTAL

Universal Trauma-Informed Care and Cultural Humility Training. After video and workshop training, staff will have ability to recognize trauma and racism and its impact on school procedures, practices, and children themselves. Staff will be able to apply core principles of cultural humility. Staff will examine their own cultural identity and how it influences their interactions and relationships with students of diverse cultural backgrounds (Principle 1). Staff will learn ways that privilege and oppression relate to their cultural identity and identify ways to flatten power hierarchies between themselves and students, including handling misbehavior from a trauma-informed, culturally humble perspective (Principle 2). Staff will problem-solve ways for their schools to be accountable for equitable discipline practices (Principle 3).

Behavioral: Immediate Universal Trauma-Informed Care and Cultural Humility Training

Waitlist Universal Trauma-Informed Care and Cultural Humility Training

ACTIVE COMPARATOR

All staff from waitlisted schools will receive Universal Trauma-Informed Care and Cultural Humility Training at the end of the waitlist period.

Behavioral: Waitlisted Universal Trauma-Informed Care and Cultural Humility Training

Interventions

Immediate Universal Trauma-Informed Care and Cultural Humility Training BEHAVIORAL

Instructional video and workshop

Immediate Universal Trauma-Informed Care and Cultural Humility Training

Waitlisted Universal Trauma-Informed Care and Cultural Humility Training BEHAVIORAL

Instructional video and workshop following waitlist period

Waitlist Universal Trauma-Informed Care and Cultural Humility Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Employees of the participating school districts
• Willingness to complete study surveys

You may not qualify if:

• School staff not employees of the participating school districts
• School staff who refuse to complete study procedures

Sponsors & Collaborators

• University of Minnesota: lead
• National Institute on Minority Health and Health Disparities (NIMHD): collaborator

Study Sites (1)

University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

Related Publications (1)

• Ramirez MR, Ryan A, Harding AB, Renfro T, Church TR, Rosebush C, Trotter AG, Xiong BN, Gonzalez J, Woods-Jaeger B. Link for Equity, a community-engaged waitlist randomized controlled trial of a culturally responsive trauma-informed care program for BIPOC students: Design features and characteristics of baseline sample. Contemp Clin Trials. 2023 Mar;126:107090. doi: 10.1016/j.cct.2023.107090. Epub 2023 Jan 18.

  PMID: 36681238 DERIVED

MeSH Terms

Conditions

Behavior

Study Officials

• Marizen Ramirez, PhD, MPH

  University of Minnesota

  PRINCIPAL INVESTIGATOR

• Andrew Ryan, MS

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 18, 2019
• First Posted: July 19, 2019
• Study Start: August 1, 2019
• Primary Completion: September 11, 2025
• Study Completion: September 11, 2025
• Last Updated: September 19, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)