Testing Peer-led Network Intervention to Prevent Adolescent Vaping

摘要 青少年吸电子烟的比率正在迅速上升。目前高中生使用电子汽化的情况 产品(EVP)从2011年的1.5%上升到2018年的20.8%-从22万增加到305万 青少年用户。蒸发与呼吸道症状有关，接触尼古丁可以起到 通往其他毒品使用的“大门”。迫切需要以学校为基础的有效干预措施来保护青少年 开始或继续使用电子病毒剂。美国卫生局局长最近的一份报告指出，没有学校或 以社区为基础的预防计划，减少年轻人的蒸发行为。这项提议需要 国家支持的预防计划的优势，以测试上述Vaping影响的有效性(ATI- v)。ATI-V列车同行提名的8-9年级同伴领袖和成人顾问。同行领导者学习技能和 利用传播学知识，在全校范围内开展预防运动。初步数据显示 在培训了大约15%的8年级学生成为同龄人领袖后，他们实施了全校范围的运动， Peer Leader的朋友的学生在第二学期减少了蒸发意图和蒸发行为 八年级。纽约州已提供资金支持学校实施ATI-V，但没有资金用于疗效 研究。在纽约州的支持和强大的调查团队的支持下，我们的项目有三个目标： 目的1.疗效。这项研究的主要目的是确定ATI-V在防止使用蒸发方面的影响(过去 30天内任何蒸发、尼古丁蒸发和常规使用)。使用随机对照试验设计，20所学校将被分配到(A) 即刻ATI-V，或(B)24个月后等待ATI-V训练的名单。大约3800名八年级学生将参加 注册并跟踪参加秋季8年级、春季8年级、春季9年级和年中10年级的评估 年级。我们将测试哪些学生的ATI-V最有效，以及在什么学校环境下(学校氛围)。 目标2.机制。本研究的第二个目的是检验ATI-V撞击的假设机制。至 为了实现这一目标，我们将对调解模型进行统计分析，以确定(A)ATI-V 改善学生对蒸发是同龄人不能接受的看法(反蒸发规范)，与 帮助成年人解决EVP问题，以及不使用电子烟的学生的社会影响；及。(二) ATI-V对减少蒸发行为的影响是通过这些改进来调节的。 目标3.实施(探索性)。我们的探索性目标是确定实施障碍和 辅导员通过收集教职员工和学生的定性数据(观察、半结构化访谈) 来自高水平和低水平实施学校的子集。其目的是确定哪些实施 未来的学校需要战略和支持才能成功地实施ATI-V，如果得到以下保证的话 这项研究发现。如果研究假设得到支持，据我们所知，这项研究将提供第一个 以学校为基础的预防干预可以减少青少年吸电子烟行为的证据。

ABSTRACT Rates of adolescent vaping are increasing rapidly. Current high school student use of electronic vaping products (EVPs) rose from 1.5% in 2011 to 20.8% in 2018 – an increase from 220,000 to 3.05 million adolescent users. Vaping is associated with respiratory symptoms, and exposure to nicotine can act as a `gateway' to other drug use. Effective, school-based interventions are urgently needed to protect adolescents from initiating or continuing use of EVPs. A recent US Surgeon General's report identified no school or community based prevention program that reduces vaping behaviors among youth. This proposal takes advantage of a state-supported prevention initiative to test the efficacy of Above the Influence of Vaping (ATI- V). ATI-V trains peer nominated 8th-9th grade Peer Leader, and adult advisors. Peer Leaders learn skills and implement school-wide prevention campaigns informed by communication science. Preliminary data show that after training approximately 15% of 8th graders as Peer Leaders, who implemented school-wide campaigns, students who were friends of Peer leader had reduced vaping intentions and vaping behaviors 2nd semester of 8th grade. New York State has provided funds to support schools to implement ATI-V but no funds for efficacy research. With support from New York State and a strong team of investigators, our project has three aims: Aim 1. Efficacy. The primary aim of this study is to determine ATI-V impact in preventing vaping use (past 30 days any vaping, nicotine vaping, and regular use). Using an RCT design, 20 schools will be assigned to (a) immediate ATI-V, or (b) wait-list for ATI-V training after 24 months. Approximately 3,800 8th graders will be enrolled and followed for assessments in fall 8th grade, spring 8th grade, spring 9th grade, and mid-year 10th grade. We will test for which students ATI-V is most effective and in what school contexts (school climate). Aim 2. Mechanism. The second aim of this study to test the hypothesized mechanisms of ATI-V impact. To accomplish this aim we will conduct statistical analyses of a mediation model to determine (a) whether ATI-V improves students' perceptions that vaping is unacceptable to their peers (anti-vaping norms), connections to supportive adults to address EVP concerns, and social influence of non-vaping students; and (b) whether the impact of ATI-V on reduced vaping behavior is mediated by these improvements. Aim 3. Implementation (Exploratory). Our exploratory aim is to identify implementation barriers and facilitators by gathering qualitative data (observations, semi-structured interviews) from staff and students from a subset of high and low implementing schools. The purpose is to identify what implementation strategies and supports are needed for future schools to be successful in implementing ATI-V, if warranted by the study findings. If study hypotheses are supported, this study will provide, to our knowledge, the first evidence of a school-based prevention intervention that reduces adolescent vaping behaviors.