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.

项目概要/摘要 美国青少年中酗酒和吸毒的比例仍然存在问题，并且青少年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。循证计划（EBP） 学校并未广泛采用减少酗酒和吸毒的措施，而且往往实施得不好。虽然 研究表明，学校在上课期间确实有时间，但多种因素影响了学校的实施效果不佳。 包括资金不足、教师流动、对项目证据缺乏信心、资金不足等 学校工作人员的支持、计划与既定目标之间的一致性较差以及缺乏技术援助 指导好落实。名为 Project ALERT 的中学毒品预防计划并实施 称为“获得结果”(GTO) 的心理支持干预措施可以解决这些因素并改善预 发明质量和青年成果。 ALERT 是一项广泛实施的免费中学计划， 转向所有在线教师培训，最近针对新药物趋势进行了更新，并且具有良好的前景 根据多个在线登记处的评级，预防吸毒和减少前体药物危险因素的作用。 GTO 是 包括培训、手册和技术援助在内的干预措施，旨在通过以下方式建设项目能力： 强化选择、计划、实施、评估和维持所需的知识、态度和技能 那些程序。之前对小型社区机构的研究已经证明了 GTO 的前景，但它的重要性 关于基于学校的预防忠诚度和青年成果的契约仍然是一个经验问题。我们提出一个 研究评估更新后的 ALERT 的有效性，并结合 GTO 实施的评估 站支持。拟议的 5 年研究比较了单独 ALERT、ALERT+GTO 和不使用 ALERT 的有效性。 混合 II 中的干预对照组，整群随机对照试验涵盖三个地区的 42 所中学 州。作为 Hybrid 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。尽管通用 GTO 工具可用，但在此 研究后我们将专门为 ALERT 定制这些工具。我们将评估这两个实施结果（例如， 人员能力、计划保真度）以及酒精、大麻、电子烟和阿片类物质使用的结果 oid 使用；以及药物前体风险因素，例如耐药自我效能、感知到的同伴规范以及彼此之间的信念 中学生3,088人。 ALERT+GTO 的成功演示可以从根本上改变证据—— 基于预防的范围和质量，大多数青少年都在美国学校。那是因为 ALERT 是一个实现 心理友好计划（免费、可访问）已被数千所学校采用 兰德公司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 ALERT—sup- 由针对 ALERT 量身定制的 GTO 工具和指南移植——将是学校最容易采用或采用的 EBP 之一 继续实施，但质量有所提高。