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

改善学校循证毒品预防计划的实施

• 批准号: 10376816
• 负责人: MATTHEW CHINMAN
• 金额: $ 62.47万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10376816
• 关键词: Address; Adherence; Adolescent; Adolescent Development; Adopted; Adult; Alcohol consumption; Alcohols; Attitude; Belief; Cigarette; Communities; Control Groups; Development; Drug Prescriptions; Drug Prevention Program; Drug usage; Educational Curriculum; Effectiveness; Electronic cigarette; Enrollment; Evaluation; Evidence based program; Funding; Future; Goals; Hour; Hybrids; Individual; Intervention; Interview; Knowledge; Lead; Legal; Manuals; Marijuana; Measures; Methods; Middle School Student; Monitor; Opioid; Outcome; Participant; Pharmaceutical Preparations; Play; Prevention; Prevention program; Prodrugs; Public Health; Quasi-experiment; Randomized; Randomized Controlled Trials; Research; Resistance; Resources; Risk; Risk Factors; Role; Schools; Self Efficacy; Students; Substance Use Disorder; System; Teacher Professional Development; Testing; Time; Training; Update; Violence; Youth; adolescent drug use; base; cohort; compare effectiveness; cost; dosage; drug abuse prevention; drug quality; drug use behavior; economic outcome; effectiveness evaluation; electronic cigarette use; evidence base; follow-up; high risk sexual behavior; implementation barriers; implementation determinants; implementation evaluation; implementation fidelity; implementation outcomes; improved; junior high school; marijuana legalization; marijuana use; novel therapeutics; online registry; opioid use; peer; prevent; process evaluation; programs; response; scale up; seventh grade; skills; substance use; substance use prevention; teacher; tool; trend; uptake

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.

项目总结/摘要 美国青年人的酒精和毒品使用率仍然存在问题，青年人使用阿片类药物的变化， 大麻和电子烟增加了预防的必要性。循证方案（EBP）， 学校没有广泛采用减少酗酒和吸毒的做法，而且往往执行不力。虽然 研究表明，学校确实有时间在上学日，多重因素影响学校的穷人， 心理状态，包括资金不足，教师流动，对计划证据缺乏信心， 学校工作人员的支持，计划与既定目标之间的不一致，以及缺乏技术援助 引导良好的实施。一个名为“警报项目”的中学毒品预防计划， 心理支持干预称为取得成果（GTO）可以解决这些因素，并改善预 预防质量和青年成果。ALERT是一个广泛实施的中学计划，是免费的， 移动到所有在线教师培训，最近更新了新的药物趋势，并有前途的evi- 预防药物使用和减少药物前风险因素的证据，由多个在线注册机构评定。GTO被 包括培训、手册和技术援助在内的干预措施，通过以下方式为项目建设能力： 加强选择、计划、实施、评估和维持所需的知识、态度和技能 这些方案。以前在小型社区机构的研究已经证明了GTO的承诺，但它的im- 关于学校预防忠诚和青年成果的契约仍然是一个经验问题。我们提出了一个 评估更新后的ALERT的有效性的研究，并结合GTO实施评估， 站支持。拟议的5年研究比较了单独使用ALERT、ALERT+GTO和不使用GTO的有效性。 干预对照组在一个混合II，集群随机对照试验的42所中学横跨三个 states.作为混合II试验，我们将测试修订后的ALERT课程和教师的有效性 培训方法以及GTO实施支持。虽然通用GTO工具是可用的，但在此 我们将专门为ALERT定制这些工具。我们将评估两种实施结果（例如， 工作人员能力，计划忠诚度）和物质使用的结果，如酒精，大麻，电子烟和阿片类药物， oid使用;以及前药物风险因素，如抵抗自我效能，感知的同伴规范和信仰， 3,088名中学生ALERT+GTO的成功演示可以从根本上改变证据- 在大多数青少年所在的美国学校，这是因为警报是一个简单的- 智力友好计划（免费，可访问）已经被数千所学校采用， 研究结束后，兰德公司将免费向学校提供所有的GTO支持。如果成功，新的ALERT-sup- 通过GTO工具和针对ALERT量身定制的指南进行移植，将是学校最容易采用的EBP之一， 继续实施，但质量有所提高。