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Testing a Trauma-Informed Prevention Program for Urban 8th Graders: The Project POWER Trial

Fri, March 22, 3:00 to 4:30pm, Hilton Baltimore, Floor: Level 2, Key 10

Integrative Statement

Introduction: Youth in disadvantaged urban areas are frequently exposed to chronic stress and trauma, including neighborhood violence and other poverty-related adversities (Breslau, Wilcox, Storr, Lucia, & Anthony, 2004; Buka, Stichick, Birdthistle, & Earls, 2001; Evans, 2004). These exposures increase risk for emotional, behavioral, and academic problems (Romeo, 2010) and ultimately, school dropout. Schools are a promising setting for addressing these issues (Atkins, Hoagwood, Kutash, & Seidman, 2010; Domitrovich et al., 2010); however, there are few universal, trauma-informed school interventions for upper middle school students. Project POWER (Promoting Options for Wellness and Emotion Regulation) is a randomized controlled trial testing the impact of RAP Club - a trauma-informed intervention for 8th graders that includes mindfulness as a core component – as compared with an active control group (a health education program). This presentation will describe key design features of the Project POWER trial, which is currently in its second year out of five.

Hypotheses: Hypotheses to be tested when data collection is complete include the following: as compared with students in the active control group, students randomized to RAP Club will demonstrate improvements in education outcomes (teacher-rated academic performance; academic record data), intermediate outcomes (e.g., behavior problems), and underlying processes (e.g., self-regulation). We will also evaluate potential moderators (e.g., baseline trauma exposure, emotional regulation) and mediators (e.g., changes in self-regulation and emotional symptoms) of RAP Club’s effects.

Study Population: The research is being conducted with eighth graders in thirty-two K-8 Baltimore City Public Schools serving low-income, predominantly African American communities. We are enrolling approximately 25 eighth graders per school. We aim to recruit a total of 800 participants, 400 in each study arm, across 32 schools over the 5-year study period.

Methods: Participants are randomized within school either to RAP Club or to Healthy Topics, the active control group. Both programs are 12 sessions delivered at school twice weekly over 6 weeks by study staff and young adult community members. We assess student emotional, behavioral, and academic outcomes using self-report surveys and teacher ratings at baseline, post-intervention, and 4-month follow up. Focus groups and interviews with students, teachers, and principals address feasibility, acceptability, fidelity, and perceived program impacts. Students complete an additional self-report survey in 9th grade. We gather students’ academic and disciplinary data for their 7th, 8th, and 9th grade years. We also collect data on program costs for an economic analysis of the intervention and active control program.

Results: We enrolled 122 participants in Cohort 1 and 150 in Cohort 2; we are currently enrolling Cohort 3. As we cannot analyze program outcomes until data collection is complete, we will present baseline sample demographic, academic, and social-emotional characteristics, as well as qualitative data from students and teachers that illustrate their experiences with the program. We will discuss challenges and lessons learned. We will also highlight notable study features, including program co-leadership by young adults from the community, building capacity of schools for continued program delivery, and identification of factors related to successful implementation to inform future program use and dissemination.

Authors