Bridge-It:: A system for predicting implementation fidelity for school-based tobacco prevention programs
Bridge-It:: A system for predicting implementation fidelity for school-based tobacco prevention programs
复制标题
DOI：
10.1007/s11121-006-0038-1
复制
发表时间：
2006-06-01
影响因子：
3.5
通讯作者：
Boerm, Melynda
中科院分区：
文献类型：
--
作者：
Gingiss, Phyllis M.;Roberts-Gray, Cynthia;Boerm, Melynda
正确实施防止烟草使用和成瘾的学校课程可将吸烟率降低高达60%。然而，由于执行不力，许多项目并不成功。在47所参与德克萨斯烟草预防倡议的中学和高中中，使用基线和两年随访收集的数据，测试了一个评估学校预防计划未来实施保真度的可能性的系统。Bridge-It系统包括一个8因素、36项调查，用于分析项目实施的能力，以及一个配套的贝叶斯模型，该模型提供了项目启动后几年实施保真度的可能性估计。该调查还询问了联邦学校预防烟草使用指导方针中建议的多个组成部分的实施活动的数量。标准参考交叉表显示，系统对实施保真度的预测在74%的情况下是正确的（p < 0.01）。回归分析证实了模型的可靠性。随访时的实施保真度由模型基线时的八个能力因子的组合来预测。它包括程序、实现支持和非程序因素。将Bridge-It系统或类似工具整合到以学校为基础的预防项目的传播和评估中，有助于增进对影响实施的因素的了解，并为能力建设提供指导。如果管理人员能够在基线上确定可能达不到实施目标的学校，那么资源分配和提供指导、培训和技术援助的计划就可以专门针对确定的需求进行调整。
Properly implemented school programs to prevent tobacco use and addiction can lower smoking prevalence up to 60%. However, numerous programs are not successful due to poor implementation. A system for estimating likelihood of future implementation fidelity of school-based prevention programs was tested using data collected at baseline and two year follow-up in 47 middle schools and high schools participating in the Texas Tobacco Prevention Initiative. The Bridge-It system includes an eight-factor, 36-item survey to analyze capacity for program implementation and a companion Bayesian model which provides estimations of likelihood of implementation fidelity several years after program initiation. The survey also asks about amount of implementing activity for each of the multiple components recommended in federal guidelines for school programs to prevent tobacco use. Criterion referenced cross-tabulations showed the system's forecast of implementation fidelity was correct in 74% of cases (p < .01). Model reliability was confirmed in regression analyses. Implementation fidelity at follow-up was predicted by the combination of the model's eight capacity factors at baseline. It includes program, implementation support, and non-program factors. Integration of the Bridge-It system, or comparable tools, into the dissemination and evaluation of school-based prevention programs can help to increase understanding of factors that influence implementation and provide guidance for capacity building. If administrators can identify at baseline schools likely to fall short of implementation goals, plans for resource allocation and provision of guidance, training, and technical assistance can be specifically tailored to identified needs.