Getting to Outcomes and Underage Drinking

描述（由申请人提供）：未成年人饮酒对社区公共卫生产生负面影响，导致交通事故，危险的性行为和酒精障碍。研究人员已经表明，有几种基于政策的策略可以用来限制未成年人获得酒精作为防止未成年人饮酒的一种方式。然而，社区在实现这些战略的研究人员所证明的成果方面面临困难。这一“差距”是因为资源有限，这些战略复杂，社区往往缺乏将“现成”战略付诸实践的能力。普通的翻译工作，如信息传播，未能改变地方一级的做法或结果，部分原因是它们没有充分建设能力或利用社区的投入。该项目将评估一种模式-取得成果-旨在帮助社区通过建设其预防能力，成功地将循证战略转化为实践。对使用GTO的联盟的研究表明，它可以帮助社区提高实施循证战略和获得健康结果的能力。本提案是对基于GTO模型的一项新干预措施--未成年饮酒问题的干预结果（GTO-UD）的评估。GTO-UD由书面的分步指南、面对面的培训和现场技术援助组成，专门用于帮助将以证据为基础的未成年人饮酒战略转化为公共政策。该项目将是一项随机对照有效性试验，具有有效性研究的要素（即，在以社区为基础的环境中实施），比较了3个使用GTO-UD的未成年人饮酒预防联盟与3个未使用GTO-UD的类似联盟。这种强调概括性和外部效度的混合设计现在被推荐用于基于社区的研究。该项目将在目标1）中提供全球技术转移组织-城市发展中心的干预措施并评价其执行情况（标准化调查和联盟成员焦点小组）;目标2）评估全球技术转移组织-城市发展中心在多大程度上改进了环境战略的翻译（重点小组、忠实度核对表、执行情况评级）;目标3）评估全球技术转移组织-预防犯罪中心在多大程度上改进了预防能力和业绩（对联盟成员进行标准化调查和访谈）;目标4）评估使用GTO-UD帮助研究翻译是否减少了未成年人饮酒和与酒精有关的撞车事故和死亡（12年级学校调查，存档撞车数据）。联盟代表将积极参与研究的所有阶段。研究结果将对社区如何实施以政策为导向的未成年人饮酒预防战略产生影响，以减少因酒精相关的撞车事故和其他负面健康结果造成的死亡，这是疾病预防控制中心国家伤害预防和控制中心的一个关键优先事项。

DESCRIPTION (provided by applicant): Underage drinking negatively impacts public health in communities, causing traffic accidents, risky sexual behaviors and alcohol disorders. Researchers have shown that there are several policy-based strategies that can be used to restrict minors' access to alcohol as a way to prevent underage drinking. However, communities face difficulty in achieving outcomes demonstrated by the researchers of these strategies. This "gap" is because resources are limited, these strategies are complex, and communities often lack the capacity to translate "off the shelf" strategies into practice. Common translation efforts, such as information dissemination, fail to change practice or outcomes at the local level in part because they do not sufficiently build capacity or use communty input. This project will assess a model-Getting To Outcomes (GTO)- designed to help communities successfully translate evidence-based strategies into practice by building their prevention capacity. Studies of coalitions who used GTO with individually focused, education-based substance abuse prevention programs have shown it can help communities improve their capacity to implement evidence based strategies and get health outcomes. This proposal is an evaluation of a new intervention based on the GTO model-Getting To Outcomes for Underage Drinking (GTO-UD). Composed of a written step by step guide, face-to-face training, and onsite technical assistance, GTO-UD has been specifically tailored to help translate the evidence-based underage drinking strategies aimed at the public policy level. The project will be a randomized controlled efficacy trial with elements of an effectiveness study (i.e., implementation in community- based setting), comparing 3 underage drinking prevention coalitions using GTO-UD with 3 similar coalitions who are not. Such blended designs that emphasize generalizability and external validity are now recommended for community-based research. The project will, in Aim 1) deliver the GTO-UD intervention and evaluate its implementation (standardized surveys and focus groups of coalition members); in Aim 2) assess how much GTO-UD improved the translation of the environmental strategies (focus groups, fidelity checklists, implementation ratings); Aim 3) assess how much GTO-UD improved prevention capacity and performance (standardized surveys and interviews of coalition members); in and in Aim 4) assess whether using GTO-UD to aid research translation reduces underage drinking and alcohol-related crashes and fatalities (12th grade school survey, archival crash data). Coalition representatives will be actively involved in all phases of the research. Results will have implications for how communities can implement policy-oriented underage drinking prevention strategies to reduce deaths due to alcohol-related crashes and other negative health outcomes, a key priority for the CDC's National Center for Injury Prevention and Control.