Preventing School Exclusion and Opioid Misuse: Effectiveness of the Inclusive Skill-building Learning Approach (ISLA)

项目摘要/摘要 广泛的研究已经证明了排外纪律和无数有害青年之间的联系。 结果包括学业成绩较低，被学校开除的可能性更大，以及 物质使用的增加和未来刑事司法的参与。做好上游预防工作，减少 青少年滥用阿片类药物和其他物质有必要在全系统范围内进行预防性检查 在学校进行干预，以减少教育工作者在实施 公平的支持。因此，“防止学校排斥和阿片类药物滥用：包容性技能的有效性-- 建立学习方法(ISLA)“正在通过Hear提交给美国国立卫生研究院 倡议(RFA-DA-23-051)。拟议的项目旨在评估ISLA的有效性，这是一个教学 和恢复性替代排除纪律，关于改善健康的社会决定因素 教育机会和质量以及社会和社区环境，以防止学校排斥和阿片类药物和 其他物质滥用。我们将进行有效性-实施混合型1群集化 在六个州的60所中学进行了对照试验。所有随机接受治疗的学生和教育工作者都将 收到ISLA，我们将评估ISLA对学生成绩的影响，从6日底到第8天结束 年级。此外，我们还将采用多种方法来了解多个级别的干预过程 学校的背景。我们的第一个目标是检查ISLA的有效性。我们将测试其直接影响 特别是：(A)排他性纪律做法(办事处 纪律转介、校内外停学、开除)；(B)学生参与；(C)包容各方 教学实践。我们还将测试ISLA对社会和社区背景的SDOH的直接影响， 具体而言：(A)师生关系；(B)学校氛围。此外，我们还将测试直接影响 关于阿片类药物和其他物质滥用及相关风险因素的信息。我们的第二个目标是研究 作为阿片类药物改变的关键机制的ISLA干预效应的调节剂和调节剂 和其他物质滥用及相关风险因素。我们将研究假定的调解效果 关于阿片类药物和其他物质滥用及相关风险因素的社会决定机制。我们 还将研究学生种族/民族和ISLA干预之间的潜在调节作用 排他性纪律做法的减少。最后，我们的第三个目标是评估执行情况 执行支助计划干预的结果，包括：(A)可行性、可用性、可接受性和保真度；(B)可持续性； 和(C)成本分析。这个项目将填补物质使用领域的一个长期空白，通过评估 上游以学校为基础的预防性干预针对并改善SDOH可能会产生有意义的影响 预防阿片类药物和其他物质滥用及相关风险因素。

PROJECT SUMMARY/ABSTRACT Extensive research has documented the link between exclusionary discipline and numerous detrimental youth outcomes including lower academic achievement, a greater likelihood of being pushed out of school, and an increase in substance use and future criminal justice involvement. To engage in upstream prevention to reduce opioid and other substance misuse among youth there is a need to examine systems-wide, preventative interventions in schools to reduce educators biased and punitive interactions with students while implementing equitable supports. Thus, “Preventing School Exclusion and Opioid Misuse: Effectiveness of the Inclusive Skill- building Learning Approach (ISLA)” is being submitted to the National Institutes of Health, through the HEAL Initiative (RFA-DA-23-051). The proposed project aims to evaluate the effectiveness of ISLA, an instructional and restorative alternative to exclusionary discipline, on improving the social determinants of health (SDOH) of education access and quality, and social and community context to prevent school exclusion and opioid and other substance misuse. We will conduct an effectiveness-implementation Hybrid Type 1 clustered randomized controlled trial in 60 middle schools across six states. All students and educators randomized to treatment will receive ISLA, and we will evaluate impacts of ISLA on student outcomes from the end of 6th to the end of 8th grade. In addition, we will incorporate methods to understand intervention processes across multiple levels of the school context. Our first aim is to examine the effectiveness of the ISLA. We will test the direct effects of ISLA on the SDOH of education access and quality, specifically: (a) exclusionary discipline practices (office discipline referrals, in- and out-of-school suspensions, expulsions); (b) student engagement; and (c) inclusive teaching practices. We will also test the direct effects of ISLA on the SDOH of social and community context, specifically: (a) student-teacher relationships; and (b) school climate. Additionally, we will test the direct effects of ISLA on opioid and other substance misuse and associated risk factors. Our second aim is to examine the mediators and moderators of ISLA intervention effects which serve as key mechanisms for change in opioid and other substance misuse and associated risk factors. We will examine the putative mediating effects of ISLA social determinant mechanisms on opioid and other substance misuse and associated risk factors. We will also examine the potential moderating effect between student race/ethnicity and the ISLA intervention on reductions in exclusionary disciplinary practices. Finally, our third aim is to evaluate the implementation outcomes of the ISLA intervention, including: (a) feasibility, usability, acceptability, and fidelity; (b) sustainment; and (c) cost analysis. This project will fill a persistent gap in the field of substance use, by evaluating whether upstream school-based preventative interventions that target and improve SDOH can have meaningful impacts on preventing opioid and other substance misuse and associated risk factors.