Research to Practice: An Indicated Prevention Program

描述：(申请人提供) 卫生服务研究中的一个关键问题是发展和 传播经过研究检验的方案，以促进有效实践。完毕 在过去的二十年里，一支规模虽小但在不断壮大的预防项目骨干队伍 在严格的实验条件下，显示出防止或减少 青少年中的药物使用和其他高危行为。虽然范围很广 资源一直被投入到疗效试验上，但却少得多。 注意当程序在现实世界环境中实现时会发生什么。 这项提案的重点是确定是否以及如何有效 当现场实际采用预防计划时，就会受到损害。这个 研究将测试有效的指示性预防措施的有效性 计划，重新连接青年(RY)，旨在降低高风险 青少年的行为。此外，这项研究将评估 影响方案实施和传播的组织因素， 以及影响其泛化和稳健性的因素。具体的 我们项目的目标是：1)进行RY的有效性试验。为了测试 计划有效性，随机对照试验将在两个 大型学区：加利福尼亚州旧金山和德克萨斯州圣安东尼奥。2)进行 RY的组织扩散研究。预测的组织因素 将分析执行的忠诚度和结果的复制，使用 在传播的指导下，对关键学校人员的采访数据 理论框架3)评估#年农村教育的制度化程度 学区。在三个学期结束时，实施资金以 学校将停课；数据收集将集中于学校是否以及如何 继续RY计划。4)开展以下工作的实施成效研究 好的。扩散理论表明，个别学校和地区将使 重大的适应，因为他们使计划制度化，并且这些 变化可能会改变计划的有效性。为了评估执行情况 有效性，参与者的结果将与学生的结果进行比较 在有效性试验中。将对工艺评估数据进行分析以评估 不同的学校和教师项目适应如何影响结果。

DESCRIPTION: (provided by applicant) A critical issue in health services research is the development and dissemination of research-tested programs to promote effective practice. Over the last two decades, a small but growing cadre of prevention programs has shown, under rigorous experimental conditions, the ability to prevent or reduce substance use and other high risk behaviors among adolescents. While extensive resources have been devoted to efficacy trials, there has been much less attention to what happens when programs are implemented in real world settings. The focus of this proposal is to determine whether and how effectiveness is compromised when prevention programs are actually adopted in the field. The study will test the effectiveness of an efficacious indicated prevention program, Reconnecting Youth (RY), which was designed to reduce high risk behaviors among adolescents. In addition, the study will assess the organizational factors affecting implementation and diffusion of the program, as well as factors affecting its generalizability and robustness. The specific aims for our project are: 1) To conduct an effectiveness trial of RY. To test program effectiveness, a randomized control trial will be conducted in two large school districts: San Francisco, CA and San Antonio, TX. 2) To conduct an organizational diffusion study of RY. Organizational factors that predict fidelity of implementation and replication of outcomes will be analyzed, using data from interviews of key school personnel, guided by the diffusion theoretical framework 3) To assess the degree of institutionalization of RY in the school districts. At the end of three semesters, implementation funding to schools will end; data collection will focus on whether and how schools continue the RY program. 4) To conduct an implementation effectiveness study of RY. Diffusion theory indicates that individual schools and districts will make significant adaptations as they institutionalize the program, and that these changes may alter program effectiveness. In order to assess implementation effectiveness, outcomes for participants will be compared to those of students in the effectiveness trial. Process evaluation data will be analyzed to assess how different school and teacher program adaptations affect outcomes.