Improving the Implementation of Evidence-based Drug Prevention Programs in Schools

项目摘要/摘要 美国年轻人的酒精和毒品使用率仍然存在问题，年轻人使用阿片类药物的变化， 大麻和电子烟增加了预防的需要。循证程序(EBP)用于再诊断 戒酒和吸毒并没有被学校广泛采用，而且往往执行不力。虽然 研究表明，学校在上学期间确实有时间，多种因素影响着学校的贫困学生-- 心理问题包括经费不足、教师流失、对课程证据缺乏信心、不足 学校教职员工的支持，计划与既定目标之间的不一致，以及缺乏技术援助 指导抓好落实。一项名为警示和实施项目的中学毒品预防计划- 被称为获得结果(GTO)的心理支持干预可以解决这些因素并改善Pre 预防质量和青年成果。Alert是一个被广泛实施的中学项目，它是免费的，有 转移到所有在线教师培训，最近更新了新的药物趋势，并承诺- 根据多个在线注册机构的评级，Dence用于预防药物使用和减少亲药物风险因素。GTO是 一种干预措施，包括培训、手册和技术援助，通过以下方式建设项目能力 加强选择、计划、实施、评估和维持所需的知识、态度和技能 那些节目。以前在小型社区机构中的研究已经证明了GTO的前景，但它的影响是-- 关于以学校为基础的预防、忠诚度和青年成果的协定仍然是一个经验性问题。我们提出了一个 研究评估最新警报的有效性，并结合对GTO实施人员的评估- 旋转支撑物。这项拟议的为期5年的研究比较了单独使用ALERT、ALERT GTO和不使用ALERT GTO的有效性。 干预对照组参加了一项混合II、整群随机对照试验，试验对象为三所中学的42所学校 各州。作为一项混合II试验，我们将测试修订后的警觉课程和教师的有效性 培训方法以及GTO的实施支持。虽然通用GTO工具可用，但在此 研究后，我们将专门为警报定制这些工具。我们将评估这两个执行成果(例如， 员工能力、计划忠诚度)以及酒精、大麻、电子烟和OPI等物质使用的结果- 使用旧毒品；以及支持毒品的风险因素，如耐药性自我效能、感知的同伴规范和 3088名中学生。警报GTO的成功演示可以从根本上改变证据- 以预防的范围和质量为基础，这是大多数年轻人都在的地方-美国的学校。这是因为警报是一种实现- 心理友好计划(免费、可访问)，已被数千所学校和 兰德将在研究结束后向学校免费提供所有GTO支持。如果成功，新的警报-sup- 由GTO工具和针对警报量身定做的指导移植-将是学校最容易采用的EBP之一，或者 继续实施，但质量有所提高。

Project Summary/Abstract US rates of alcohol and drug use among youth remain problematic, and changes in youth use of opioids, marijuana, and e-cigarettes have increased the need for prevention. Evidence-based programs (EBPs) for re- ducing alcohol and drug use are not widely adopted by schools and are often implemented poorly. Although studies show that schools do have time during the school day, multiple factors influence schools’ poor imple- mentation including inadequate funding, teacher turnover, lack of confidence in program evidence, insufficient support from school staff, poor alignment between programs and stated goals, and lack of technical assistance to guide good implementation. A middle-school drug prevention program called Project ALERT and imple- mentation support intervention called Getting To Outcomes (GTO) can address these factors and improve pre- vention quality and youth outcomes. ALERT is a widely implemented middle-school program that is free, has moved to all online teacher training, has been recently updated for new drug trends, and has promising evi- dence for preventing drug use and reducing pro-drug risk factors, as rated by multiple online registries. GTO is an intervention which includes training, manuals, and technical assistance that builds capacity for programs by strengthening the knowledge, attitudes, and skills needed to choose, plan, implement, evaluate, and sustain those programs. Previous studies in small community agencies have demonstrated GTO’s promise, but its im- pact on school-based prevention fidelity and youth outcomes remains an empirical question. We propose a study to assess the effectiveness of the updated ALERT in combination with an assessment of GTO implemen- tation support. The proposed 5-year study compares the effectiveness of ALERT alone, ALERT+GTO, and a no- intervention control group in a Hybrid II, cluster-randomized controlled trial of 42 middle schools across three states. As a Hybrid II trial, we will test both the effectiveness of the revised ALERT curriculum and teacher training method as well as the GTO implementation support. Although generic GTO tools are available, in this study we will tailor those tools specifically for ALERT. We will evaluate both implementation outcomes (e.g., staff capacity, program fidelity) and outcomes of substance use such as alcohol, marijuana, e-cigarette, and opi- oid use; and pro-drug risk factors such as resistance self-efficacy, perceived peer norms, and beliefs among 3,088 middle-schoolers. A successful demonstration of ALERT+GTO could fundamentally transform evidence- based prevention’s reach and quality where most youth are—US schools. That is because ALERT is an imple- mentation-friendly program (free, accessible) that is already being employed by thousands of schools and RAND would offer all the GTO support to schools for free after the study. If successful, the new ALERT—sup- ported by GTO tools and guidance tailored to ALERT—would be one of the easiest EBPs for schools to adopt or continue implementing but with improved quality.