Optimizing a community-engaged multi-level group intervention to reduce substance use: an application of the multiphase optimization strategy.
Optimizing a community-engaged multi-level group intervention to reduce substance use: an application of the multiphase optimization strategy.
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DOI：
10.1186/s13063-018-2624-5
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发表时间：
2018-04-27
期刊：
影响因子：
2.5
通讯作者：
Newark Community Collaborative Board (NCCB)
中科院分区：
文献类型：
--
作者：
Windsor LC;Benoit E;Smith D;Pinto RM;Kugler KC;Newark Community Collaborative Board (NCCB)
酒精和非法药物使用（AIDU）的比率在各种族群体中始终相似（温莎和Negi，J Addict Dis 28：258-68，2009; Keyes等人，Soc Sci Med 124：132-41，2015）。然而，AIDU对非洲裔美国人集中的贫困社区的居民有更大的影响（DCAA -即，贫困率和犯罪率高的地区），这些人获得药物使用障碍有效治疗的机会也少得多。该项目正在优化Community Wise，这是一项创新的多层次行为健康干预措施，与服务提供者和有SUD和监禁历史的贫困社区居民合作创建，以减少与AIDU相关的健康不平等。基于批判意识理论、社区参与性研究原则（CBPR）和多阶段优化策略（MOST），本研究采用2 × 2 × 2 × 2析因设计，设计出最有效、最有效、最具竞争力的研究方法，可扩展版本的Community Wise，价格为美元这项研究完全有能力检测居住在美国新泽西州纽瓦克的528名有SUD和监禁史的男性样本中AIDU的变化。一个社区协作委员会使用各种战略监督招聘，包括土著实地工作人员抽样、基于设施的抽样、通过传单进行社区广告和街头宣传。参与者被随机分配到16个条件之一，其中包括以下候选干预组件的组合：同行或许可的主持人，小组对话，个人目标发展和社区组织。所有参与者都获得了核心的批判性思维组件。在基线时收集数据，并进行5次基线后每月随访。一旦确定了优化的Community Wise干预措施，将在未来的随机临床试验中根据现有的护理标准对其进行评估。本文介绍了有史以来第一次使用CBPR和MOST优化针对边缘化人群的物质使用干预研究的协议。这项研究的数据将最终优化社区智慧手册;增强方法战略，利用MOST和CBPR制定多组件可扩展的干预措施;更好地理解批判意识理论在与AIDU相关的健康不平等领域的应用。ClinicalTrials.gov，NCT02951455。于2016年11月1日注册。本文的在线版本（10.1186/s13063-018-2624-5）包含补充材料，可供授权用户使用。
Rates of alcohol and illicit drug use (AIDU) are consistently similar across racial groups (Windsor and Negi, J Addict Dis 28:258–68, 2009; Keyes et al. Soc Sci Med 124:132–41, 2015). Yet AIDU has significantly higher consequences for residents in distressed communities with concentrations of African Americans (DCAA - i.e., localities with high rates of poverty and crime) who also have considerably less access to effective treatment of substance use disorders (SUD). This project is optimizing Community Wise, an innovative multi-level behavioral-health intervention created in partnership with service providers and residents of distressed communities with histories of SUD and incarceration, to reduce health inequalities related to AIDU. Grounded in critical consciousness theory, community-based participatory research principles (CBPR), and the multiphase optimization strategy (MOST), this study employs a 2 × 2 × 2 × 2 factorial design to engineer the most efficient, effective, and scalable version of Community Wise that can be delivered for US$250 per person or less. This study is fully powered to detect change in AIDU in a sample of 528 men with a histories of SUD and incarceration, residing in Newark, NJ in the United States. A community collaborative board oversees recruitment using a variety of strategies including indigenous field worker sampling, facility-based sampling, community advertisement through fliers, and street outreach. Participants are randomly assigned to one of 16 conditions that include a combination of the following candidate intervention components: peer or licensed facilitator, group dialogue, personal goal development, and community organizing. All participants receive a core critical-thinking component. Data are collected at baseline plus five post-baseline monthly follow ups. Once the optimized Community Wise intervention is identified, it will be evaluated against an existing standard of care in a future randomized clinical trial. This paper describes the protocol of the first ever study using CBPR and MOST to optimize a substance use intervention targeting a marginalized population. Data from this study will culminate in an optimized Community Wise manual; enhanced methodological strategies to develop multi-component scalable interventions using MOST and CBPR; and a better understanding of the application of critical consciousness theory to the field of health inequalities related to AIDU. ClinicalTrials.gov, NCT02951455. Registered on 1 November 2016. The online version of this article (10.1186/s13063-018-2624-5) contains supplementary material, which is available to authorized users.
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