Enhancing School-Based Violence Prevention

Enhancing School-Based Violence Prevention Through Multilevel Racial/Ethnic Discrimination Intervention

The purpose of this study is to compare two versions of Mental Health Enhanced Positive Behavioral Interventions and Supports in reducing aggression in middle school students.

Study Overview

• Status: Completed
• Conditions: Aggressive Childhood Behavior
• Intervention / Treatment: Behavioral: Mental Health Enhanced Positive Behavioral Interventions and Supports (PBIS-MH); Behavioral: Racial/Ethnic Discrimination Interventions (RED)

• Study Type: Interventional
• Enrollment (Actual): 4840
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • South Carolina
    • Charleston, South Carolina, United States, 29407
      • Name and state withheld to protect anonyminty of study site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 10 years to 105 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• for student participants: in 6th and 7th grades in a study school at study entry
• for teacher participants: teacher at a study school

Exclusion Criteria:

• .for student participants: intellectual disabilities, very limited reading abilities, or in foster care

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Mental Health-Enhanced PBIS; Mental health-enhanced Positive Behavioral Interventions and Supports (PBIS-MH) integrates mental health into the three core elements of PBIS. 1) School-based mental health clinicians are included on leadership teams. 2) Data from teacher and student perceived school climate, as well as universal screening for aggression and mental health difficulties, are used to inform intervention decision-making. 3) Evidence-based mental health prevention and intervention practices are layered into PBIS' three-tiered continuum.	Behavioral: Mental Health Enhanced Positive Behavioral Interventions and Supports (PBIS-MH); Mental health-enhanced Positive Behavioral Interventions and Supports (PBIS-MH) integrates mental health into the three core elements of PBIS. 1) School-based mental health clinicians are included on leadership teams. 2) Data from teacher and student perceived school climate, as well as universal screening for aggression and mental health difficulties, are used to inform intervention decision-making. 3) Evidence-based mental health prevention and intervention practices are layered into PBIS' three-tiered continuum.; Other Names: Interconnected Systems Framework
Experimental: Mental Health-Enhanced PBIS + RED; PBIS-MH+RED involves the components of PBIS-MH integrated with racial/ethnic discrimination interventions (RED) to address multiple forms of school-based racial and ethnic discrimination. 1) Unintentional bias training for school personnel, involving teaching participants to conceptualize prejudice as well as strategies to reduce bias. 2) Unintentional bias training for students that is delivered in a classroom in a developmentally appropriate lesson format. 3) Vulnerable Decision Point process: Leadership teams are trained to reduce disparities in school discipline by a) using disaggregated student discipline data to identify particular settings or practices that are drivers for racial/ethnic disproportionality in a school and b) using iterative problem-solving to address these drivers. 4) Teacher stress reduction training where they are provided with strategies to reduce stress.	Behavioral: Mental Health Enhanced Positive Behavioral Interventions and Supports (PBIS-MH); Mental health-enhanced Positive Behavioral Interventions and Supports (PBIS-MH) integrates mental health into the three core elements of PBIS. 1) School-based mental health clinicians are included on leadership teams. 2) Data from teacher and student perceived school climate, as well as universal screening for aggression and mental health difficulties, are used to inform intervention decision-making. 3) Evidence-based mental health prevention and intervention practices are layered into PBIS' three-tiered continuum.; Other Names: Interconnected Systems Framework; Behavioral: Racial/Ethnic Discrimination Interventions (RED); Racial/Ethnic Discrimination Interventions are a set of components to address multiple forms of school-based racial and ethnic discrimination. 1) Unintentional bias training for school personnel, involving teaching participants to conceptualize prejudice as well as strategies to reduce bias. 2) Unintentional bias training for students that is delivered in a classroom in a developmentally appropriate lesson format. 3) Vulnerable Decision Point process: Leadership teams are trained to reduce disparities in school discipline by a) using disaggregated student discipline data to identify particular settings or practices that are drivers for racial/ethnic disproportionality in a school and b) using iterative problem-solving to address these drivers. 4) Teacher stress reduction training where they are provided with strategies to reduce stress.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change from baseline in student report on aggression as measured by the Reactive and Proactive Aggression Survey	The Reactive and Proactive Aggression Survey is a self-report instrument assessing how often the respondent has behaved aggressively towards other children over the past three months. Scores range from 0 (Never) to 5 (All of the time)	Fall of year 1 (average of October), spring of years 1 and 2 (average of May)
Mean change from baseline in teacher report on students' aggression as measured by the Teacher Report of Aggression	The Teacher Report of Aggression is a teacher-report survey completed by teachers assessing a student's tendency to be aggressive. Scores range from 1 (Never) to 5 (All of the time)	Fall of year 1 (average of October), spring of years 1 and 2 (average of May)
Mean change from baseline in student aggression as measured by the number of Office Discipline Referrals per month	Office Discipline Referrals are official school records recorded for each behavioral infraction warranting referral to the school office. Office Discipline Referrals for aggressive behavior (i.e. bullying, fighting, making threats) will be counted. The minimum score is 0 an there is no maximum score.	From first day of school in year 1 to last day of school in year 2

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in student report on discrimination from teachers as measured by the Adolescent Discrimination Index - Educational Discrimination Distress Subscale	The Adolescent Discrimination Index is a self-report survey assessing the respondent's own experiences of racial/ethnic discrimination. The Education subscale assesses discrimination from school teachers.The respondent indicates whether they have experienced discrimination, either Yes or No. If the respondent selects Yes, they rate how upsetting the experience was with scores ranging from 1 (Not at all) to 5 (Extremely)	Fall of year 1 (average of October), spring of years 1 and 2 (average of May)
Change from baseline in student report on discrimination from peers as measured by the Adolescent Discrimination Index - Peer Discrimination Distress Subscale	The Adolescent Discrimination Index is a self-report survey assessing the respondent's own experiences of racial/ethnic discrimination. The Peer subscale assesses discrimination from peers. The respondent indicates whether they have experienced discrimination, either Yes or No. If the respondent selects Yes, they rate how upsetting the experience was with scores ranging from 1 (Not at all) to 5 (Extremely)	Fall of year 1 (average of October), spring of years 1 and 2 (average of May)

Collaborators and Investigators

• Sponsor: Medical University of South Carolina
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD)

Study record dates

Study Major Dates

• Study Start (Actual): September 13, 2019
• Primary Completion (Actual): December 31, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: September 11, 2019
• First Submitted That Met QC Criteria: September 11, 2019
• First Posted (Actual): September 12, 2019

Study Record Updates

• Last Update Posted (Actual): January 20, 2026
• Last Update Submitted That Met QC Criteria: January 16, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Aberrant Motor Behavior in Dementia; Behavioral Symptoms; Aggression; Therapeutics; Patient Care; Health Services; Health Care Facilities Workforce and Services; Palliative Care
• Other Study ID Numbers: 00085255; 1R01MD013812-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No