Adoption and Implementation Support Innovations for PROSPER Partnership-Based EBI

描述（由申请人提供）： 拟议研究的目的是通过国家伙伴关系网络，促进针对青少年健康风险行为的循证干预措施（EBI）的传播。为此，拟议的研究将评估 EBI 实施支持策略，该策略旨在促进更广泛地传播经经验验证的国家伙伴关系模型，有效连接现有的 EBI 交付系统。青少年中物质使用和其他危害健康的问题行为的流行病学数据以及旨在预防此类问题的持续、高质量的 EBI 实施的缺乏表明了拟议研究的必要性。成功和持续的 EBI 实施需要家庭、学校和社区之间的持续合作，并提供积极的技术援助模式来支持他们。我们的 PROSPER 合作伙伴关系模式将公立学校系统与称为合作推广系统的土地赠款大学传播系统以及各州的其他预防规划资源联系起来。它经过二十年由美国国立卫生研究院资助的随机对照预防试验的发展，并已证明了一系列积极的、长期的公共卫生影响。由于通过公立学校和其他青年计划传播系统提供的预防活动通常不利用 EBI，特别是那些以可持续方式高质量实施的预防活动，因此需要将我们的模式推广到更多州和社区。需要进一步开发和测试合作伙伴采用和实施支持组件。我们建议对代表来自所有 50 个州的赠地大学合作推广、公立学校和公共卫生系统的关键信息提供者进行基于网络的调查，以评估可能影响 PROSPER 伙伴关系模型采用的社交网络和准备情况因素，并对各州作为早期采用者的准备程度进行排名（目标 1）。利用州调查数据中的信息选择四个州，我们将对包含激励辅导的合作伙伴采用决策团队支持策略进行评估（目标 2）。最后，我们将在选定的合作就绪州的农村社区开展受控试点研究（目标 3）。这将涉及提供 PROSPER 模型培训和实施支持组件，以及新开发的基于网络的实施流程和结果评估系统。这项试点工作将使我们能够评估影响 EBI 实施质量和 EBI 结果的一系列系统和组织因素。它还将揭示与在没有我们的合作伙伴模式的情况下在州和联邦资金支持下开展常规预防活动的同一州的社区站点相比，PROSPER 社区站点是否表现出更高质量的 EBI 实施和更强的成果。 公共卫生相关性： 目前有有限的随机纵向研究评估如何以最佳方式维持对一般人群的循证干预措施 (EBI) 的质量实施，以实现对青少年吸烟、其他物质使用和其他问题行为（例如攻击行为）的人群水平影响。过去二十年的调查开展了基于社区-大学伙伴关系的预防试验，形成了一个经过经验验证的模型，支持高质量、持续实施普通人群 EBI。过去的试点工作表明，承诺具体采用和实施支持该模型（称为 PROSPER 网络模型）在多个州站点更广泛的传播，并通过拟议的研究进一步开发和测试。

DESCRIPTION (provided by applicant): The purpose of the proposed research is to advance the dissemination of evidence-based interventions (EBIs) targeting youth health-risking behaviors, through a network of state partnerships. Toward this end, the proposed research will evaluate EBI implementation support strategies designed to facilitate broader dissemination of an empirically-validated state partnership model that effectively links existing EBI delivery systems. The need for the proposed research is indicated by epidemiological data on substance use and other health-risking problem behaviors among adolescents and by the dearth of sustained, quality implementation of EBIs designed to prevent such problems. Successful and sustained EBI implementation necessitates sustained partnerships among families, schools, and communities with a proactive technical assistance model to support them. Our PROSPER partnership model links the public school system with the land grant university dissemination system called the Cooperative Extension System and other resources in states for prevention programming. It has evolved through two decades of NIH-funded, randomized-controlled prevention trials, and has demonstrated a range of positive, long-term public health impacts. Because prevention activities offered through public schools and other youth program dissemination systems often do not utilize EBIs, particularly ones that are implemented with quality and in a sustainable way, there is a need to reach more states and communities with our model. Further development and testing of partnership adoption and implementation support components is required. We propose to conduct web-based surveys of key informants representing the land grant university Cooperative Extension, Public School, and Public Health systems from all 50 states, to assess social network and readiness factors potentially influencing the adoption of the PROSPER partnership model and to rank states on level of readiness as early adopters (Aim 1). Using information from the state survey data to select four states, we will conduct an evaluation of a partnership adoption decision-making team support strategy that incorporates motivational coaching (Aim 2). Finally, we will conduct a controlled pilot study with rural community sites in a selected partnership-ready state (Aim 3). This will involve the provision of PROSPER model training and implementation support components, along with a newly-developed web-based implementation process and outcome evaluation system. This pilot work will allow us to evaluate a range of system and organizational factors influencing the quality of EBIs implemented and EBI outcomes. It also will reveal whether PROSPER community sites show higher quality implementation of EBIs and stronger outcomes, as compared with community sites in the same states conducting usual prevention activities supported by state and federal funding, absent our partnership model. PUBLIC HEALTH RELEVANCE: There has been limited randomized, longitudinal study evaluating how to optimally sustain quality implementation of evidence-based interventions (EBIs) for general populations, in order to achieve population- level effects on youth smoking, other substance use, and other problem behaviors, such as aggression. Community-university partnership-based prevention trials conducted by the investigations over the past two decades have resulted in an empirically-validated model that supports high-quality, sustained implementation of general population EBIs. Past pilot work suggests the promise of specific adoption and implementation supports for broader dissemination of the model (called the PROSPER Network Model) in multiple state sites, to be further developed and tested through the proposed research.