Enhancing the Impact of Evidence-Based Prevention for Youth: The Rapid Adaption to Prevent Drug Use (RAPD) Implementation Strategy

增强青少年循证预防的影响：快速适应预防吸毒 (RAPD) 实施策略

• 批准号: 10510068
• 负责人: Andria B Eisman
• 金额: $ 23.1万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10510068
• 关键词: Address; Adolescent; Adopted; Attention; COVID-19; Communities; Cost Analysis; Costs and Benefits; Data; Drug usage; Early Intervention; Educational Curriculum; Effectiveness; Event; Evidence based intervention; Family; Foundations; Future; Goals; Health; Health behavior; Health education; Health system; Health trends; Hybrids; Infrastructure; Intervention; Low income; Methods; Michigan; Modeling; Morbidity - disease rate; Pharmaceutical Preparations; Phase; Population; Poverty; Prevention; Process; Public Health; Recording of previous events; Reporting; Research; Research Proposals; Resources; Risk; Schools; Shapes; Societies; Students; Substance Use Disorder; Support System; System; Testing; Time; Training; Trauma; Update; Youth; base; comparative; coronavirus disease; cost; cost effectiveness; cost outcomes; design; drug abuse prevention; drug misuse; drug standard; economic evaluation; evidence base; implementation evaluation; implementation outcomes; implementation science; implementation strategy; improved; innovation; mortality; multiple drug use; novel; novel therapeutics; pilot test; programs; rapid test; rapid testing; response; risk perception; skills; social exclusion; stakeholder perspectives; stem; teacher; trend; vaping

Drug use trends change rapidly among youth, leaving intervention experts struggling to respond to emerging drugs promptly. We have a critical need to advance implementation strategies to optimize system responsiveness to these emerging issues. COVID-19 has increased the urgency for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts. Tier 1 evidence-based interventions (EBIs), such as the Michigan Model for HealthTM (MMH) lend themselves to addressing emerging trends. Our overall objectives are to 1) Improve the responsiveness of school-based EBIs in addressing urgent issues and 2) Find ways to support teachers in implementing updated EBIs, attending to unique considerations of low-resource schools. We will use After Action Review (AAR), to guide the systematic design of RAPD, Rapid Adaptation to Prevent Drug use, a novel bundle of implementation strategies. AAR is a reflective process focused on improving public health systems’ rapid response capacity. Key phases of AAR include: 1) Objective observation; 2) Analyze gaps/best practices, 3) Identify and test suitable implementation strategies to improve responsiveness to the next event (e.g., COVID-related drug use escalation). Sustainable strategies are central to achieving our objectives. Thus, we will also conduct a preliminary stakeholder-focused cost analysis. The rationale for this research is that designing and testing RAPD will enhance schools’ capacity to respond to urgent drug issues sustainably, and provide up-to-date, relevant resources for effective and equitable prevention. The proposed research will address the following aims: Aim 1: Identify implementation gaps and best practices in responding to urgent drug use events. We will use AAR to review the statewide response to the vaping crisis using the MMH using rapid qualitative analysis and identify gaps to be addressed with RAPD. Aim 2: Design and pilot test RAPD implementation and effectiveness. We will design a RAPD to optimize responses to urgent drug use events and pilot test in schools serving low-income students to assess equity. We will assess implementation outcomes using a convergent mixed methods design, and effectiveness via a group RCT comparing RAPD and standard MMH implementation. Aim 3: Assess costs and benefits of RAPD from multiple stakeholder perspectives. We will use an exploratory sequential mixed methods design to understand and identify key costs and outcomes from key stakeholder perspectives. We will develop a costing guide and conduct a preliminary cost analysis to inform an economic evaluation for a larger trial. The proposed research is innovative because to date implementation strategies have not been designed to support systems in responding to changing public health trends with attention to equity. In addition, this study focuses on implementation strategies to reduce the health impact of emerging drugs and provide an infrastructure to make future adaptations that can be applied in other contexts. The proposed research is significant because it will advance applying implementation science to achieve access, cost and equity for drug use prevention.

青少年吸毒趋势迅速变化，使干预专家难以应对新出现的 药物及时我们迫切需要推进实施战略，以优化系统 应对这些新出现的问题。COVID-19增加了实施科学的紧迫性， 利用现有的治疗和预防努力，促进迅速、公平的反应。1级循证 干预措施（EBI），如密歇根州健康模式TM（MMH），有助于解决新兴的 趋势我们的整体目标是：1）改善校本EBI的回应能力， 问题和2）找到支持教师实施最新EBI的方法，注意独特的考虑因素 低资源学校。我们将使用事后回顾（AAR）来指导RAPD的系统设计， 快速适应以预防吸毒，一套新的实施战略。AAR是一种反射 这一进程的重点是提高公共卫生系统的快速反应能力。AAR的关键阶段包括：1） 客观观察; 2）分析差距/最佳做法，3）确定和测试适当的实施战略， 提高对下一事件的响应性（例如，COVID相关药物使用升级）。可持续战略 是实现我们目标的核心。因此，我们还将进行初步的以业主为中心的成本核算， 分析.这项研究的基本原理是，设计和测试RAPD将提高学校的能力， 可持续地应对紧迫的毒品问题，并提供最新的相关资源， 公平预防。拟议的研究将针对以下目标：目标1：确定执行情况 在应对紧急吸毒事件方面的差距和最佳做法。我们将使用AAR来审查全州的 使用快速定性分析的MMH应对vaping危机，并确定需要解决的差距 用RAPD。目的2：设计和试点测试RAPD的实施和有效性。我们将设计一个RAPD， 优化对紧急吸毒事件的反应，并在为低收入学生服务的学校进行试点测试，以评估 股权我们将使用融合的混合方法设计和有效性来评估实施结果 通过一组随机对照试验比较RAPD和标准MMH的实施。目标3：评估 从多个利益相关者的角度进行RAPD。我们将使用探索性序贯混合方法设计， 从主要利益相关者的角度理解并确定主要成本和成果。我们将制定一个成本计算 指导并进行初步成本分析，为更大规模试验的经济评估提供信息。拟议 研究是创新的，因为迄今为止的实施战略还没有被设计为支持系统 在应对不断变化的公共卫生趋势时，注意公平。此外，本研究还关注 实施战略，以减少新兴药物对健康的影响，并提供基础设施， 未来的调整可以应用于其他环境。这项研究意义重大，因为它将 推动应用执行科学，以实现预防吸毒的可及性、成本和公平。