Link for Schools: an Evaluation of a Tiered Staff Training Program and Student Intervention to Prevent Violence

NCT05196893 | Completed

• 2 other identifiers: 2017057122016-CK-BX-0006
• Study Type: interventional
• Target: 863
• Locations: 1 country
• Sites: 3

Brief Summary

The University of Iowa in collaboration with the Cedar Rapids Community School District (CRCSD) conducted an effectiveness study to test a theory-based system, called Link, that trained school staff to provide a sustainable infrastructure of support for youth at-risk of violence. Our purpose was to prevent and intervene in violence that impacts students, and to adopt cost-effective school-based violence prevention strategies. The research team conducted a randomized intervention trial with three "clusters" of within the CRCSD using the procedures described in the following paragraph. Each cluster consisted of a middle school and three "feeder" elementary schools. Implementation of the program began in Fall 2017 at Cluster 1, Fall 2018 at Cluster 2, and Cluster 3 remained a control site and received no intervention. Program Implementation, by Cluster: A series of videos were produced by the University of Iowa team in conjunction with the CRCSD, and were offered as a training opportunity to school staff. The series of video trainings include: Trauma Informed Care (TIC) video to be viewed by all staff; and a Link Program training video for select staff. TIC video instructions was required of all staff during a workshop session. Participants were invited to complete a post-training evaluation survey following the viewing of the TIC video, for research. Concurrent with the delivery of the Trauma Informed Care video training, select staff were identified by the CRCSD research team to become Link interventionists, by participating in specialized training of the Link system using the Link Program video and in-person trainings. These interventionists had a dual role as a study participant and as a member of the research team. These interventionists were provided 4 in-person trainings throughout the school year that included training in child assent procedures, and Link Program training. These interventionists were invited to complete pre/post evaluation surveys at each training session, for research. Targeted Research Intervention: Following the Link Program Training, the CRCSD research team randomly assigned a case load of students to the Link interventionists with whom they used the Link Program skills. Following each student encounter, the interventionist completed a Link Case Management Tool for process evaluation. Link interventionists were also invited to complete a pre-evaluation survey prior to Link Program training, and post-evaluation surveys following training sessions. Data collected for the targeted student intervention included: primary data in the form of a Link Case Management Tool completed by a Link interventionist following each student encounter; secondary data in the form of existing school administrative data sources (i.e., enrollment and office referrals).

Conditions

Risk Reduction Behavior

Keywords

School violence prevention

Outcome Measures

Primary Outcomes (3)

• Change in weekly rate of student office referrals (overall)

  A mean weekly rate of overall disciplinary office referrals was calculated using counts of student disciplinary office referrals received per academic week, for all referral types. To determine the effectiveness of the intervention in reducing the rate of referrals, negative binomial models were fitted using Generalized Estimating Equations (GEEs); the first model focused on the amount of time each student was in the study and the second model determined if there was a dosage effect with the number of intervention sessions received. Each of these models included covariates (sex, race, and grade level) to account for the differences between the students' demographic groups.

  weekly, up to 3 academic years

• Change in weekly rate of student office referrals (physical aggression)

  A mean weekly rate of physical aggression office referrals was calculated using counts of student office referrals related to physical aggression, received per academic week. To determine the effectiveness of the intervention in reducing the rate of referrals, negative binomial models were fitted using Generalized Estimating Equations (GEEs); the first model focused on the amount of time each student was in the study and the second model determined if there was a dosage effect with the number of intervention sessions received. Each of these models included covariates (sex, race, and grade level) to account for the differences between the students' demographic groups.

  weekly, up to 3 academic years

• Change in student K-6 stress screener score

  Score of individual student stress, measured using the Kessler-6 (K-6) "Six Simple Questions" stress screener. Interventionists were trained to assess student stress on an as needed basis during intervention sessions, and on at least two occasions: 1) at the start of the student's intervention (during first session), and 2) prior to ending or tapering intervention sessions.

  every two weeks, up to 3 academic years

Study Arms (3)

Immediate Student Intervention Group

EXPERIMENTAL

Eligible students who were randomized into an immediate intervention group, and received intervention from school staff who received specialized intervention training starting in the fall semester of the academic year. Students from two clusters of schools received staggered intervention (Cluster 1 starting in year 1, and Cluster 2 starting in year 2). School staff recorded details of intervention sessions in a case management tool, and administrative records were maintained by the school district, for evaluation purposes.

Behavioral: Link Intervention

Wait-list Student Intervention Group

EXPERIMENTAL

Eligible students who were randomized into a wait-list intervention group, and received intervention from school staff who received specialized intervention training starting in the spring semester of the academic year. Students from two clusters of schools received staggered intervention (Cluster 1 starting in year 1, and Cluster 2 starting in year 2). School staff recorded details of intervention sessions in a case management tool, and administrative records were maintained by the school district, for evaluation purposes.

Behavioral: Link Intervention

Within School Student Control Group

NO INTERVENTION

Eligible students who were randomized into either the immediate or wait-list intervention groups, but did not receive intervention from school staff. This was used as a control group instead of an intended 3rd Cluster, which ultimately was not a comparable control based on enrollment and demographic characteristics.

Interventions

Link Intervention BEHAVIORAL

Eligible students met with staff trained in specialize intervention skills. Staff met with students multiple times per month, for approximately 10-30 minutes. During these sessions, staff had conversations with students, using intervention communication skills, assessed student stress, and implemented strategies for behavior change. Details of the sessions were recorded in a case management tool. Students were referred to additional resources, as necessary, and these referrals were also recorded. Rates of student office referrals were assessed over time.

Immediate Student Intervention Group; Wait-list Student Intervention Group

Eligibility Criteria

• Age: 5 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• \. Elementary and middle school students in grades 3- 8 from clusters 1 and 2, who:
• Have one or more behavioral referrals in the previous academic year, or
• Have at least 2 of the following indicators in the previous academic year:
• attended 80% or less of enrolled school days,
• were in the 90th percentile and above on tardies,
• had changed schools since the previous year,
• were not proficient in ELA (tested only in 6th and 7th grade),
• were in the 10th percentile or below on math performance,
• were in the 90th percentile or above on health office visits, or
• scored positive on the district-administered Pediatric Symptom Checklist.

You may not qualify if:

• Students unable to proficiently communicate in English

Sponsors & Collaborators

• Karen Heimer: lead
• U.S. Department of Justice: collaborator
• University of Minnesota: collaborator
• Cedar Rapids Community School District: collaborator

Study Sites (3)

Cedar Rapids Community School District

Cedar Rapids, Iowa, 52405, United States

Location

University of Iowa

Iowa City, Iowa, 52242, United States

Location

University of Minnesota

Minneapolis, Minnesota, 55455, United States

Location

MeSH Terms

Conditions

Risk Reduction Behavior

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Karen Heimer, PhD

  University of Iowa

  PRINCIPAL INVESTIGATOR

• Marizen R Ramirez, PhD, MPH

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This study is a two-level randomized intervention trial of students from 12 schools in three clusters.

Study Record Dates

• First Submitted: December 7, 2021
• First Posted: January 19, 2022
• Study Start: August 1, 2017
• Primary Completion: July 1, 2020
• Study Completion: June 1, 2021
• Last Updated: January 19, 2022

Record last verified: 2022-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, ANALYTIC CODE
• Time Frame: Data will be made publicly available upon successful curation by NACJD.
• Access Criteria: Data will be publicly available.

Locations

US (3)