Owora Arthur H, Salaam Najah, Russell Leed Sydney H, Bergen-Cico Dessa, Jennings-Bey Timothy, El Arnett Haygood, Rubinstein Robert A, Lane Sandra D
1Department of Public Health, Falk College, Syracuse University, Syracuse, NY 13244 USA.
Street Addiction Inc., Syracuse, New York USA.
Pilot Feasibility Stud. 2018 Sep 14;4:147. doi: 10.1186/s40814-018-0339-8. eCollection 2018.
Our study objective was to examine the feasibility of implementing a culturally congruent mentorship pilot program, Youth-First (YF), that targets behavior modification among elementary school-aged children with disruptive behavior and a history of school suspension. We hypothesize that it is feasible to implement the YF program to reduce disruptive behaviors and recidivism of level III/IV infractions in school settings among at-risk African American students.
We assessed program feasibility based on the success of program acceptance by parents/guardians, study enrollment, and intervention compliance by students. A pre/posttest study design was used to examine whether the YF program reduced recidivism of disruptive behavior among enrolled at-risk African American elementary school children between September 2016 and January 2017. Generalized linear mixed models examined whether student behavioral scores improved over time and varied by program mentor. A McNemar test examined the reduction in cumulative incidence of level III/IV infractions pre-post YF program intervention.
Intervention acceptance, enrollment, and compliance were 100% (95% confidence interval [CI] 86 to 100%), 100% (95% CI 86 to 100%), and 67% (95% CI 45 to 84%), respectively ( = 24). Overall, student behavioral scores improved and plateaued over time (Time effect: = - 0.01, 95% CI - 0.02, < 0.01); a two-week period was associated with a seven-point improvement (effect size: Cohen's = 0.47, 95% CI 0.03, 0.94) in behavioral scores. Behavioral score improvements were class-specific, based on respectfulness behavior ( = 0.11, 95% CI < 0.01, 0.26). No recidivism of level III/IV infractions was reported during and post YF intervention.
The integration of culturally congruent mentorship in elementary school-settings is feasible and can reduce risk of disruptive behaviors among at-risk African American students. Future studies should use randomized clinical trials to determine the effectiveness of culturally congruent mentorship interventions (void of potential selection and confounding biases) in reducing disruptive behavior, level III/IV infractions, and school suspensions among at-risk children.
我们的研究目的是检验实施一项文化适配的指导试点项目“青年优先”（Youth-First，简称YF）的可行性，该项目针对有破坏性行为且有学校停学记录的小学适龄儿童进行行为矫正。我们假设，实施YF项目以减少高危非裔美国学生在学校环境中的破坏性行为和三级/四级违规行为的再犯率是可行的。
我们根据家长/监护人对项目的接受程度、研究招募情况以及学生的干预依从性来评估项目的可行性。采用前后测试研究设计，以检验YF项目是否降低了2016年9月至2017年1月期间入学的高危非裔美国小学生中破坏性行为的再犯率。广义线性混合模型检验了学生行为评分是否随时间改善以及是否因项目导师而异。McNemar检验考察了YF项目干预前后三级/四级违规累计发生率的降低情况。
干预接受率、招募率和依从率分别为100%（95%置信区间[CI]86%至100%）、100%（95%CI 86%至100%）和67%（95%CI 45%至84%）（n = 24）。总体而言,学生行为评分随时间改善并趋于平稳（时间效应：β = -0.01，95%CI -0.02，<0.01）；两周时间与行为评分提高7分相关（效应量：科恩d值 = 0.47，95%CI 0.03，0.94）。行为评分的改善因班级而异，基于尊重行为（β = 0.11，95%CI <0.01，0.26）。在YF干预期间及之后，未报告三级/四级违规行为的再犯情况。
在小学环境中整合文化适配的指导是可行的，并且可以降低高危非裔美国学生出现破坏性行为的风险。未来的研究应使用随机临床试验来确定文化适配的指导干预措施（无潜在选择和混杂偏倚）在减少高危儿童的破坏性行为、三级/四级违规行为和学校停学方面的有效性。
