Alcohol Drinking, Bullying, Depressive Symptoms, Social Acceptance
Conditions
Keywords
Sexual and gender minority youth
Brief summary
This pilot cluster-randomized controlled trial will evaluate the PLANTS (Providing LGBTQ+ Adolescents with Nurturance, Trustworthiness, and Safety) course among high school staff. The primary hypotheses are that the PLANTS course will have high acceptability, usability, appropriateness, and feasibility as reported by high school staff.
Detailed description
The intervention being studied, PLANTS, is an online-delivered training program, including asynchronous and synchronous activities targeting high school staff. This intervention is informed by the Information-Motivation-Behavior theory to target high school staffs' skills, self-efficacy, knowledge, and outcome expectations. Members of the study population as well as collaborators invested in Sexual and Gender Minority Youth (SGMY) well-being provided valuable feedback on PLANTS throughout its development. Comparison schools will receive the email-based control intervention, E-learning to Maximize Academic Inclusion of LGBTQ+ Students (EMAILS). Staff will receive periodic emails with publicly available resources on similar topics to those of PLANTS. Regarding the intervention's targeted behavioral outcomes, upon completion of the PLANTS program, high school staff will: provide interpersonal support and affirmation to SGMY; provide educational resources that are inclusive of SGMY; provide safe spaces for SGMY; promote acceptance of SGMY among cisgender heterosexual youth; prevent and reduce bullying, cyberbullying, and harassment of SGMY; evaluate and advocate for SGMY inclusivity and protections in school policies; and maintain the confidentiality of SGMY. By having high school staff achieve these behavioral outcomes, the investigators hypothesize that SGMY will experience less risk factors (e.g., bullying victimization) and more protective factors (e.g., school-based adult support), which will in turn reduce SGMY's substance use and mental health problems. The primary aim of this clinical trial is to rigorously test the acceptability, usability, appropriateness, and feasibility of the PLANTS intervention using a 2-armed cluster-randomized controlled trial. The investigators will also examine the efficacy of intervention in improving high school staff outcomes as well as implementation and safety outcomes related to the intervention and trial. Results from this pilot trial will provide necessary information to conduct a fully powered trial of the efficacy of PLANTS for reducing the ultimate health outcome of SGMY alcohol use.
Interventions
BEHAVIORALPLANTS
PLANTS intervention is an online-delivered training program, including asynchronous and synchronous activities. This intervention was informed by the Information-Motivation-Behavior theory to target skills, self-efficacy, knowledge, and outcome expectations. There are 3 asynchronous online modules that cover a variety of topics including lessons on LGBTQ+ terminology, names and pronouns, resources, antibullying, gender neutral bathrooms, student confidentiality, active empathic listening, and school policies. Module include recorded presentations, student testimonials, activities, and downloadable resources for future reference. Every month, 7-9 lessons are opened. There are 2 synchronous group events delivered via Zoom and are 1.5 hours each.
BEHAVIORALEMAILS
The active control arm is an email-based intervention, EMAILS, in which existing public resources for supporting, affirming, and protecting LGBTQ+ students are emailed to participants.
Sponsors
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
This is an unblinded study. This is an educational intervention that cannot be blinded because study participants will be able to tell which condition they are in based on the content they receive.
Intervention model description
This is a two-armed cluster-randomized controlled pilot trial of the PLANTS intervention versus an active control group, the EMAILS intervention. The investigators will randomize schools in an equal 1:1 ratio, stratified by large versus small schools, into intervention or active control conditions. The investigators will use block randomization with block sizes of 2, which will be stratified by large schools versus not, where large is ≥1000 students. The investigators use block size of 2 because there are only 4 schools in this pilot trial.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Currently employed by an enrolled school in the MetroWest Region of Boston, Massachusetts * Age 18 years old or older * Consents to participate
Exclusion criteria
• Does not interact with high school students at work
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Value of Acceptability of Intervention Measure | Approximately 4 months after intervention deployment | At follow-up, participants will complete the four-question Acceptability of Intervention Measure (AIM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean acceptability value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more acceptable the intervention. |
| Mean Score on the System Usability Scale | Approximately 4 months after intervention deployment | At follow-up, participants will complete the ten-question System Usability Scale (SUS) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Strongly agree) to 5 (Strongly disagree). The odd-numbered question responses will be reverse coded. All items will be summed and that sum will be multiplied by 2.5 to produce the final SUS value (ranging from 0-100). The higher the computed value, the more useable the intervention. |
| Mean Value of Intervention Appropriateness Measure | Approximately 4 months after intervention deployment | At follow-up, participants will complete the four-question Intervention Appropriateness Measure (IAM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean appropriateness value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more appropriate the intervention. |
| Mean Value of Feasibility of Intervention Measure | Approximately 4 months after intervention deployment | At follow-up, participants will complete the four-question Feasibility of Intervention Measure (FIM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean feasibility value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more feasible the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Baseline and follow-up (approximately 4 months after baseline) | The investigators have developed items pertaining directly to PLANTS' self-efficacy change objectives. Participants will complete each item using a five-point Likert scale, where 1 represents not at all certain and 5 represents extremely certain. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater self-efficacy. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in self-efficacy from baseline to follow-up. |
| Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Baseline and follow-up (approximately 4 months after baseline) | Participants will complete the 16-item Teacher Bystander Intervention Model in Traditional Bullying scale, which has five subscales. Each response will be coded on a scale of 1 to 5, with 1 representing strongly disagree and 5 representing strongly agree. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater skills related to bystander intervention in bullying. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in bystander intervention skills from baseline to follow-up. |
| Trial Participation Rate | Baseline | The investigators will divide the number of school staff who consent to participate by the total number of school staff who are invited, then multiply by 100 to get a percentage. |
| Change in Mean Scores on the Modified Gay Affirmative Practice Scale | Baseline and follow-up (approximately 4 months after baseline) | The investigators have modified the language of the Gay Affirmative Practice Scale to incorporate school-oriented words instead of therapy-oriented words to measure self-efficacy for school staff working with SGMY. Participants will complete the nine-item scale at baseline and follow-up, with each item using a five-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater self-efficacy. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in self-efficacy from baseline to follow-up. |
| Safety Outcomes | At follow-up (approximately 4 months after baseline) | Investigators assess myriad safety outcomes including parent backlash, social media backlash, school board backlash, suspension or removal from employment, censorship of LGBTQ+ literature/history/stories or removal of books with LGBTQ+ representation from school libraries, and emotional discomfort with intervention and control conditions at follow-up. Response options include frequency of each event occurrence (none, once, twice, 3-9 times, and 10 or more times). Investigators will report the overall frequency of events, frequency of each type of event, and percentage of school staff reporting any event. |
| Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Baseline and follow-up (approximately 4 months after baseline) | Participants will complete the 16-item Teacher Bystander Intervention Model in Cyberbullying scale, which has five subscales. Each response will be coded on a scale of 1 to 5, with 1 representing strongly disagree and 5 representing strongly agree. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater skills related to bystander intervention in cyberbulling. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in bystander intervention skills from baseline to follow-up. |
| Trial Retention Rate | At follow-up (approximately 4 months after baseline) | The investigators will divide the number of school staff who complete the follow-up survey by the total number of school staff who were enrolled, then multiply by 100 to get a percentage. |
| Intervention Demand | At follow-up (approximately 4 months after baseline) | The investigators will divide the number of participants who adhere to the PLANTS intervention by the total number of school staff who were enrolled at schools randomly assigned the PLANTS intervention and multiply by 100 to obtain a percentage. Adherence is a composite variable ranging from 0-100% comprised of: 55% for online module completion (based on the number of completed items divided by the total number of items offered); 45% for Live Zoom Event attendance (where each event is 15%). |
| Change in Mean Scores on the Active-Empathic Listening Scale | Baseline and follow-up (approximately 4 months after baseline) | Participants will complete the eleven-item Active-Empathic Listening Scale at baseline and follow-up. Each item uses a seven-point Likert scale for responses, coded from 1 (never or almost never true) to 7 (Always or almost always true). Mean scores will be calculated for all eleven items at each time point. The minimum possible mean value is 1 and the maximum mean value is 7. Higher values represent greater active-empathic listening. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in active-empathic listening from baseline to follow-up. |
Countries
United States
Participant flow
Pre-assignment details
In this pilot study, fewer school staff joined this study than anticipated.
Participants by arm
| Arm | Count |
|---|---|
| PLANTS Schools will receive the online-delivered PLANTS intervention, which includes 3 asynchronous training modules and 3 synchronous group events.
PLANTS: PLANTS intervention is an online-delivered training program, including asynchronous and synchronous activities. This intervention was informed by the Information-Motivation-Behavior theory to target skills, self-efficacy, knowledge, and outcome expectations. There are 3 asynchronous online modules that cover a variety of topics including lessons on LGBTQ+ terminology, names and pronouns, resources, antibullying, gender neutral bathrooms, student confidentiality, active empathic listening, and school policies. Module include recorded presentations, student testimonials, activities, and downloadable resources for future reference. Every month, 7-9 lessons are opened. There are 2 synchronous group events delivered via Zoom and are 1.5 hours each. | 67 |
| EMAILS Comparison schools will receive emails with publicly available resources for supporting LGBTQ+ students as a control intervention.
EMAILS: The active control arm is an email-based intervention, EMAILS, in which existing public resources for supporting, affirming, and protecting LGBTQ+ students are emailed to participants. | 28 |
| Total | 95 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 33 | 14 |
| Overall Study | Withdrawal by Subject | 1 | 1 |
Baseline characteristics
| Characteristic | PLANTS | EMAILS | Total |
|---|---|---|---|
| Age, Continuous | 44.04 years | 44.90 years | 44.30 years |
| Childhood Religion Catholicism | 41 Participants | 15 Participants | 56 Participants |
| Childhood Religion Judaism | 2 Participants | 2 Participants | 4 Participants |
| Childhood Religion Multiple religions | 2 Participants | 0 Participants | 2 Participants |
| Childhood Religion None | 9 Participants | 5 Participants | 14 Participants |
| Childhood Religion Protestantism | 9 Participants | 4 Participants | 13 Participants |
| Childhood Religion Something else | 2 Participants | 1 Participants | 3 Participants |
| Childhood Religion Unknown | 2 Participants | 1 Participants | 3 Participants |
| Current Religion Catholicism | 14 Participants | 5 Participants | 19 Participants |
| Current Religion Judaism | 2 Participants | 2 Participants | 4 Participants |
| Current Religion Multiple Religions | 1 Participants | 1 Participants | 2 Participants |
| Current Religion None | 44 Participants | 16 Participants | 60 Participants |
| Current Religion Protestantism | 4 Participants | 1 Participants | 5 Participants |
| Current Religion Something Else | 1 Participants | 2 Participants | 3 Participants |
| Current Religion Unknown | 1 Participants | 1 Participants | 2 Participants |
| Education Completed Bachelor's degree | 6 Participants | 0 Participants | 6 Participants |
| Education Completed Doctorate degree | 3 Participants | 1 Participants | 4 Participants |
| Education Completed Master's degree | 55 Participants | 25 Participants | 80 Participants |
| Education Completed Professional degree beyond bachelor's degree | 2 Participants | 1 Participants | 3 Participants |
| Education Completed Some college | 1 Participants | 1 Participants | 2 Participants |
| Intrinsic Religiosity | 2.26 units on a scale STANDARD_DEVIATION 1.12 | 1.96 units on a scale STANDARD_DEVIATION 1.04 | 2.18 units on a scale STANDARD_DEVIATION 1.1 |
| Previous Online Training about LGBTQ+ Issues No or not sure | 64 Participants | 21 Participants | 85 Participants |
| Previous Online Training about LGBTQ+ Issues Yes | 3 Participants | 7 Participants | 10 Participants |
| Previous Training about LGBTQ+ Issues No or not sure | 39 Participants | 14 Participants | 53 Participants |
| Previous Training about LGBTQ+ Issues Yes | 28 Participants | 14 Participants | 42 Participants |
| Race/Ethnicity, Customized Asian | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Black or African American | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Hispanic | 1 Participants | 1 Participants | 2 Participants |
| Race/Ethnicity, Customized Unknown | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized White | 65 Participants | 25 Participants | 90 Participants |
| Region of Enrollment United States | 67 participants | 28 participants | 95 participants |
| Religious Activity | 1.90 units on a scale STANDARD_DEVIATION 1.4 | 1.79 units on a scale STANDARD_DEVIATION 1.34 | 1.86 units on a scale STANDARD_DEVIATION 1.38 |
| Religious Attendance | 2.16 units on a scale STANDARD_DEVIATION 1.16 | 1.96 units on a scale STANDARD_DEVIATION 1.07 | 2.11 units on a scale STANDARD_DEVIATION 1.13 |
| Role in School Administrator | 2 Participants | 3 Participants | 5 Participants |
| Role in School Counselor or psychologist | 4 Participants | 1 Participants | 5 Participants |
| Role in School Multiple roles | 5 Participants | 0 Participants | 5 Participants |
| Role in School Other certified staff | 3 Participants | 1 Participants | 4 Participants |
| Role in School Paraprofessional, teacher assistant, or instructional aide | 2 Participants | 1 Participants | 3 Participants |
| Role in School Special education teacher | 5 Participants | 2 Participants | 7 Participants |
| Role in School Teacher | 45 Participants | 19 Participants | 64 Participants |
| Role in School Unknown | 1 Participants | 1 Participants | 2 Participants |
| Sex/Gender, Customized Cisgender man | 15 Participants | 9 Participants | 24 Participants |
| Sex/Gender, Customized Cisgender woman | 51 Participants | 19 Participants | 70 Participants |
| Sex/Gender, Customized Nonbinary | 1 Participants | 0 Participants | 1 Participants |
| Sexual Identity Bisexual | 2 Participants | 1 Participants | 3 Participants |
| Sexual Identity Gay or lesbian | 7 Participants | 3 Participants | 10 Participants |
| Sexual Identity Heterosexual (straight) | 58 Participants | 22 Participants | 80 Participants |
| Sexual Identity Queer | 0 Participants | 2 Participants | 2 Participants |
| Social Desirability | 4.71 units on a scale STANDARD_DEVIATION 0.33 | 5.27 units on a scale STANDARD_DEVIATION 0.5 | 4.88 units on a scale STANDARD_DEVIATION 0.27 |
| Years Worked at School | 16.34 years | 17.44 years | 16.65 years |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 69 | 0 / 30 |
| other Total, other adverse events | 0 / 69 | 0 / 30 |
| serious Total, serious adverse events | 0 / 69 | 0 / 30 |
Outcome results
Primary
Mean Score on the System Usability Scale
At follow-up, participants will complete the ten-question System Usability Scale (SUS) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Strongly agree) to 5 (Strongly disagree). The odd-numbered question responses will be reverse coded. All items will be summed and that sum will be multiplied by 2.5 to produce the final SUS value (ranging from 0-100). The higher the computed value, the more useable the intervention.
Time frame: Approximately 4 months after intervention deployment
Population: Intervention participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Mean Score on the System Usability Scale | 75.47 score on a scale |
p-value: 0.82795% CI: [71.12, 79.83]t-test, 2 sided
Primary
Mean Value of Acceptability of Intervention Measure
At follow-up, participants will complete the four-question Acceptability of Intervention Measure (AIM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean acceptability value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more acceptable the intervention.
Time frame: Approximately 4 months after intervention deployment
Population: Intervention participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Mean Value of Acceptability of Intervention Measure | 3.93 score on a scale |
p-value: 0.07495% CI: [3.73, 4.13]t-test, 2 sided
Primary
Mean Value of Feasibility of Intervention Measure
At follow-up, participants will complete the four-question Feasibility of Intervention Measure (FIM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean feasibility value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more feasible the intervention.
Time frame: Approximately 4 months after intervention deployment
Population: Intervention participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Mean Value of Feasibility of Intervention Measure | 4.01 score on a scale |
p-value: 0.00295% CI: [3.85, 4.18]t-test, 2 sided
Primary
Mean Value of Intervention Appropriateness Measure
At follow-up, participants will complete the four-question Intervention Appropriateness Measure (IAM) about PLANTS. Each question uses a five-point Likert scale for responses, coded with a value from 1 (Completely disagree) to 5 (Completely agree) and averaged to produce the mean appropriateness value. The minimum possible mean value is 1 and the maximum mean value is 5. The higher the computed mean value, the more appropriate the intervention.
Time frame: Approximately 4 months after intervention deployment
Population: Intervention participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Mean Value of Intervention Appropriateness Measure | 4.01 score on a scale |
p-value: 0.00395% CI: [3.84, 4.17]t-test, 2 sided
Secondary
Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety
The investigators have developed items pertaining directly to PLANTS' self-efficacy change objectives. Participants will complete each item using a five-point Likert scale, where 1 represents not at all certain and 5 represents extremely certain. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater self-efficacy. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in self-efficacy from baseline to follow-up.
Time frame: Baseline and follow-up (approximately 4 months after baseline)
Population: Participants who completed the follow-up survey
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| PLANTS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in LGBTQ+ Inclusivity, Awareness, and Advocacy | 0.70 units on a scale |
| PLANTS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in Identity-Affirming Practices | 0.26 units on a scale |
| PLANTS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in Inclusivity in Restrooms and Changing Options | 0.43 units on a scale |
| EMAILS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in LGBTQ+ Inclusivity, Awareness, and Advocacy | 0.45 units on a scale |
| EMAILS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in Identity-Affirming Practices | 0.13 units on a scale |
| EMAILS | Change in Mean Scores on Self-efficacy Change Objectives for Providing LGBTQ+ Adolescents With Nurturance, Trustworthiness, and Safety | Self-Efficacy in Inclusivity in Restrooms and Changing Options | 0.44 units on a scale |
p-value: <0.00195% CI: [0.46, 0.95]Mixed Models Analysis
p-value: 0.0195% CI: [0.1, 0.8]Mixed Models Analysis
p-value: 0.00195% CI: [0.11, 0.41]Mixed Models Analysis
p-value: 0.0195% CI: [0.03, 0.24]Mixed Models Analysis
p-value: 0.00195% CI: [0.18, 0.68]Mixed Models Analysis
p-value: 0.0495% CI: [0.02, 0.86]Mixed Models Analysis
Secondary
Change in Mean Scores on the Active-Empathic Listening Scale
Participants will complete the eleven-item Active-Empathic Listening Scale at baseline and follow-up. Each item uses a seven-point Likert scale for responses, coded from 1 (never or almost never true) to 7 (Always or almost always true). Mean scores will be calculated for all eleven items at each time point. The minimum possible mean value is 1 and the maximum mean value is 7. Higher values represent greater active-empathic listening. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in active-empathic listening from baseline to follow-up.
Time frame: Baseline and follow-up (approximately 4 months after baseline)
Population: Participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Change in Mean Scores on the Active-Empathic Listening Scale | 0.22 units on a scale |
| EMAILS | Change in Mean Scores on the Active-Empathic Listening Scale | 0.01 units on a scale |
p-value: 0.0395% CI: [0.03, 0.42]Mixed Models Analysis
p-value: 0.9595% CI: [-0.36, 0.38]Mixed Models Analysis
Secondary
Change in Mean Scores on the Modified Gay Affirmative Practice Scale
The investigators have modified the language of the Gay Affirmative Practice Scale to incorporate school-oriented words instead of therapy-oriented words to measure self-efficacy for school staff working with SGMY. Participants will complete the nine-item scale at baseline and follow-up, with each item using a five-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater self-efficacy. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in self-efficacy from baseline to follow-up.
Time frame: Baseline and follow-up (approximately 4 months after baseline)
Population: Participants who completed the follow-up survey
| Arm | Measure | Value (MEAN) |
|---|---|---|
| PLANTS | Change in Mean Scores on the Modified Gay Affirmative Practice Scale | 0.44 units on a scale |
| EMAILS | Change in Mean Scores on the Modified Gay Affirmative Practice Scale | 0.49 units on a scale |
p-value: <0.00195% CI: [0.28, 0.59]Mixed Models Analysis
p-value: <0.00195% CI: [0.29, 0.69]Mixed Models Analysis
Secondary
Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale
Participants will complete the 16-item Teacher Bystander Intervention Model in Cyberbullying scale, which has five subscales. Each response will be coded on a scale of 1 to 5, with 1 representing strongly disagree and 5 representing strongly agree. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater skills related to bystander intervention in cyberbulling. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in bystander intervention skills from baseline to follow-up.
Time frame: Baseline and follow-up (approximately 4 months after baseline)
Population: Participants who completed the follow-up survey
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Interpret the event as an emergency | -0.02 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Know how to intervene | 0.39 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Accept responsibility for intervening | -0.07 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Implement intervention decisions | -0.01 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Notice the event | -0.15 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Implement intervention decisions | 0.14 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Notice the event | -0.21 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Interpret the event as an emergency | 0.05 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Accept responsibility for intervening | -0.12 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Cyberbullying Scale | Know how to intervene | 0.12 units on a scale |
p-value: 0.0895% CI: [-0.32, 0.02]Mixed Models Analysis
p-value: 0.295% CI: [-0.55, 0.12]Mixed Models Analysis
p-value: 0.7495% CI: [-0.14, 0.1]Mixed Models Analysis
p-value: 0.5595% CI: [-0.12, 0.23]Mixed Models Analysis
p-value: 0.495% CI: [-0.22, 0.09]Mixed Models Analysis
p-value: 0.3695% CI: [-0.37, 0.13]Mixed Models Analysis
p-value: <0.00195% CI: [0.18, 0.6]Mixed Models Analysis
p-value: 0.4195% CI: [-0.16, 0.39]Mixed Models Analysis
p-value: 0.9295% CI: [-0.22, 0.2]Mixed Models Analysis
p-value: 0.3795% CI: [-0.16, 0.44]Mixed Models Analysis
Secondary
Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale
Participants will complete the 16-item Teacher Bystander Intervention Model in Traditional Bullying scale, which has five subscales. Each response will be coded on a scale of 1 to 5, with 1 representing strongly disagree and 5 representing strongly agree. Mean scores will be calculated for all items at each time point. The minimum possible mean value is 1 and the maximum mean value is 5. Higher values represent greater skills related to bystander intervention in bullying. The mean scores from baseline will be subtracted from the mean scores from follow-up to produce the change in mean scores. Higher values represent greater increases in bystander intervention skills from baseline to follow-up.
Time frame: Baseline and follow-up (approximately 4 months after baseline)
Population: Participants who completed the follow-up survey
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Interpret the event as an emergency | -0.19 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Know how to intervene | 0.33 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Accept responsibility for intervening | -0.15 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Implement intervention decisions | -0.06 units on a scale |
| PLANTS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Notice the event | -0.23 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Implement intervention decisions | -0.03 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Notice the event | -0.24 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Interpret the event as an emergency | 0.02 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Accept responsibility for intervening | 0.07 units on a scale |
| EMAILS | Change in Mean Scores on the Teacher Bystander Intervention Model in Traditional Bullying Scale | Know how to intervene | 0.28 units on a scale |
p-value: 0.195% CI: [-0.5, 0.04]Mixed Models Analysis
p-value: 0.1495% CI: [-0.55, 0.07]Mixed Models Analysis
p-value: 0.0795% CI: [-0.39, 0.01]Mixed Models Analysis
p-value: 0.8595% CI: [-0.18, 0.22]Mixed Models Analysis
p-value: 0.0695% CI: [-0.3, 0.01]Mixed Models Analysis
p-value: 0.5195% CI: [-0.14, 0.28]Mixed Models Analysis
p-value: 0.00195% CI: [0.13, 0.53]Mixed Models Analysis
p-value: 0.0495% CI: [0.01, 0.55]Mixed Models Analysis
p-value: 0.3695% CI: [-0.19, 0.07]Mixed Models Analysis
p-value: 0.6295% CI: [-0.16, 0.1]Mixed Models Analysis
Secondary
Intervention Demand
The investigators will divide the number of participants who adhere to the PLANTS intervention by the total number of school staff who were enrolled at schools randomly assigned the PLANTS intervention and multiply by 100 to obtain a percentage. Adherence is a composite variable ranging from 0-100% comprised of: 55% for online module completion (based on the number of completed items divided by the total number of items offered); 45% for Live Zoom Event attendance (where each event is 15%).
Time frame: At follow-up (approximately 4 months after baseline)
Population: Intent-to-treat intervention population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PLANTS | Intervention Demand | 60.80 percentage of enrolled staff |
Secondary
Safety Outcomes
Investigators assess myriad safety outcomes including parent backlash, social media backlash, school board backlash, suspension or removal from employment, censorship of LGBTQ+ literature/history/stories or removal of books with LGBTQ+ representation from school libraries, and emotional discomfort with intervention and control conditions at follow-up. Response options include frequency of each event occurrence (none, once, twice, 3-9 times, and 10 or more times). Investigators will report the overall frequency of events, frequency of each type of event, and percentage of school staff reporting any event.
Time frame: At follow-up (approximately 4 months after baseline)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| PLANTS | Safety Outcomes | Overall number of events | 6 events |
| PLANTS | Safety Outcomes | Times contacted by parents/guardians because there was too much LGBTQ+ inclusivity in school | 0 events |
| PLANTS | Safety Outcomes | Times contacted by people who were upset because you supported LGBTQ+ students | 0 events |
| PLANTS | Safety Outcomes | Times your school was attacked for supporting LGBTQ+ youth | 0 events |
| PLANTS | Safety Outcomes | Times your school board got upset or concerned about staff supporting LGBTQ+ youth | 0 events |
| PLANTS | Safety Outcomes | Times received negative consequences from your employer about supporting LGBTQ+ youth | 0 events |
| PLANTS | Safety Outcomes | Times LGBTQ+ censorship happened in your school | 0 events |
| PLANTS | Safety Outcomes | Times uncomfortable while participating in the course | 6 events |
| EMAILS | Safety Outcomes | Times uncomfortable while participating in the course | 1 events |
| EMAILS | Safety Outcomes | Overall number of events | 8 events |
| EMAILS | Safety Outcomes | Times your school board got upset or concerned about staff supporting LGBTQ+ youth | 0 events |
| EMAILS | Safety Outcomes | Times contacted by parents/guardians because there was too much LGBTQ+ inclusivity in school | 1 events |
| EMAILS | Safety Outcomes | Times LGBTQ+ censorship happened in your school | 0 events |
| EMAILS | Safety Outcomes | Times contacted by people who were upset because you supported LGBTQ+ students | 0 events |
| EMAILS | Safety Outcomes | Times received negative consequences from your employer about supporting LGBTQ+ youth | 0 events |
| EMAILS | Safety Outcomes | Times your school was attacked for supporting LGBTQ+ youth | 6 events |
Secondary
Trial Participation Rate
The investigators will divide the number of school staff who consent to participate by the total number of school staff who are invited, then multiply by 100 to get a percentage.
Time frame: Baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PLANTS | Trial Participation Rate | 19.9 percentage of total school staff |
Secondary
Trial Retention Rate
The investigators will divide the number of school staff who complete the follow-up survey by the total number of school staff who were enrolled, then multiply by 100 to get a percentage.
Time frame: At follow-up (approximately 4 months after baseline)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| PLANTS | Trial Retention Rate | 50.7 percentage of consented staff |
| EMAILS | Trial Retention Rate | 49.3 percentage of consented staff |