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Community Randomized Trial in the Cherokee Nation: CONNECT and CMCA for Preventing Drug Misuse among Older Adolescents

切罗基族社区随机试验：CONNECT 和 CMCA 预防老年青少年药物滥用

基本信息

批准号：
10208334
负责人：
KELLI Ann KOMRO
金额：
$ 116.43万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10208334
关键词：
Adolescence Adolescent Adolescent and Young Adult Age Alcohol consumption American Indians Award Cherokee Indian Collaborations Communities Cost Effectiveness Analysis Disease Drug usage Employee Funding Goals Individual Institutional Review Boards Intervention Measures Mediator of activation protein Modeling Monitor Multimedia Oklahoma Opioid Outcome Outcome Measure Pharmaceutical Preparations Phase Population Prevention Prevention strategy Prevention trial Preventive Intervention Procedures Process Protocols documentation Public Health Randomized Research Research Personnel Risk Rural Rural Community Schools Science Scientific Advances and Accomplishments Scientist Site Social Network Social support Standardization Structure Students Suicide prevention Surveys System Testing Universities Youth alcohol and other drug base behavioral health brief intervention caucasian American cohort community intervention cost cost effectiveness critical developmental period design drug abuse prevention drug misuse evidence base follow-up high risk high school improved innovation marijuana use misuse of prescription only drugs opioid epidemic opioid misuse prevent programs randomized trial recruit screening and brief intervention staff intervention success tenth grade theories therapy design underage drinking young adult

项目摘要

Abstract The national public health opioid crisis has disproportionately burdened rural white populations, and disproportionately burdened American Indian populations. Therefore, the Cherokee Nation (CN) and Emory University public health scientists have designed an opioid prevention trial to be conducted in at-risk rural communities in the CN (in northeast Oklahoma) with white and American Indian adolescents and young adults. Our goal is to implement and evaluate a theory-based, integrated multi-level community intervention designed to prevent the onset and escalation of opioid and other drug misuse. Two distinct intervention approaches— community organizing as implemented in our established CMCA intervention protocol, and universal school- based brief intervention and referral as implemented in our established CONNECT intervention protocol—will be expanded and integrated to further enhance their effects in preventing and reducing opioid misuse. The CMCA and CONNECT interventions were originally designed to target adolescent alcohol use, but nevertheless showed significant beneficial effects on use of other drugs, including prescription drug misuse. The proposed study will: (1) further improve the design of the interventions with increased focus on opioids, (2) test the expanded, integrated versions in a community randomized trial, and (3) design and test new systems for sustained implementation within existing structures of the Cherokee Nation. Building upon the extant prevention science evidence, our study will respond to a gap in evidence concerning opioid misuse prevention among at-risk adolescents transitioning to young adulthood among American Indian and other rural youth. Our previous trial, conducted in partnership with the Cherokee Nation ended with youth attaining age 18; the proposed new trial will additionally advance the science regarding strategies to engage young adults as they transition beyond high school. During the UG3 planning phase we will (1) expand and integrate a theory-based multi-level preventive intervention package for the critical developmental period of late adolescence to young adulthood, (2) develop implementation, proximal and opioid and other drug use outcome measures, and (3) prepare for the initiation of the trial. During the UH3 trial phase we will (1) implement interventions through Cherokee Nation and measure implementation processes and fidelity, (2) measure proximal and opioid and other drug use outcomes every six months among a cohort of 10th grade students from 16 schools followed over three years through their transition out of high school, (3) test via a community randomized trial the effect of the integrated CMCA-CONNECT intervention, and (4) analyze implementation costs and cost-effectiveness. This trial will expand upon our previous research to substantially advance the scientific evidence regarding prevention of opioid and other drug misuse during the critical developmental period of late adolescent transitions to young adulthood.

摘要