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，以促进有效的实践。超过 在过去的二十年里，一个规模不大但不断增长的预防项目骨干队伍， 在严格的实验条件下， 物质使用和其他青少年高危行为。虽然广泛 资源一直致力于疗效试验，有少得多 注意当程序在真实的世界环境中实施时会发生什么。 本提案的重点是确定是否以及如何有效地 当预防方案实际上在实地采用时，这一点就会受到损害。的 研究将测试有效指示预防的有效性 计划，重新连接青年（RY），旨在减少高风险 青少年的行为。此外，该研究将评估 影响方案实施和推广的组织因素， 以及影响其普遍性和鲁棒性的因素。具体 本课题的主要目的是：1）进行RY的有效性试验。测试 计划的有效性，随机对照试验将在两个 大型学区：加利福尼亚州旧金山弗朗西斯科和德克萨斯州圣安东尼奥。2)进行一次 组织扩散研究。预测的组织因素 将使用以下方法分析执行和复制成果的保真度： 数据来自重点学校人员的访谈，以扩散为导向， （3）为评估南斯拉夫社会主义联邦共和国的制度化程度， 学区。在三个学期结束时， 学校将结束;数据收集将集中在学校是否和如何 继续执行RY计划。4)进行实施成效研究， 瑞。扩散理论表明，个别学校和地区将使 他们在将该计划制度化时进行了重大调整， 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。将对过程评价数据进行分析， 不同的学校和教师课程调整如何影响结果。

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.