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

项目总结/摘要 广泛的研究记录了排他性纪律和许多有害的青年之间的联系 结果包括较低的学业成绩，更大的可能性被赶出学校， 药物使用增加和未来刑事司法参与。从事上游预防，以减少 青年人滥用阿片类药物和其他药物，有必要审查全系统的预防性措施， 在学校采取干预措施，减少教育工作者与学生的偏见和惩罚性互动， 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）”正在提交给美国国立卫生研究院，通过HEAL 倡议（RFA-DA-23-051）。拟议项目的目的是评估ISLA的有效性， 关于改善健康的社会决定因素的报告（SDOH） 教育机会和质量以及社会和社区背景，以防止学校排斥和类阿片 其他物质滥用。我们将进行一个有效性实施混合类型1集群随机 在6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将 接受ISLA，我们将评估ISLA对学生成绩的影响，从6日结束到8日结束 年级此外，我们将纳入方法，以了解干预过程中的多个层次， 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 ISLA关于SDOH的教育机会和质量，特别是：（a）排斥性纪律做法（办公室 纪律转介，校内和校外停学，开除）;（B）学生参与;（c）包容性 教学实践。我们还将测试ISLA对社会和社区背景下的SDOH的直接影响， 具体而言：（a）师生关系;及（B）学校气氛。此外，我们还将测试 关于阿片类药物和其他药物滥用及相关风险因素的国际空间法。我们的第二个目标是检查 ISLA干预效应的介导者和调节者，作为阿片类药物变化的关键机制 以及其他药物滥用和相关风险因素。我们将研究假设的中介效应， ISLA阿片类药物和其他药物滥用的社会决定因素机制及相关风险因素。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， 减少排斥性的纪律措施。最后，我们的第三个目标是评估执行情况 ISLA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; （三）成本分析。该项目将填补物质使用领域的一个长期空白，评估是否 以学校为基础的上游预防性干预措施，针对和改善SDOH可以产生有意义的影响 预防阿片类药物和其他药物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.