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，促进针对青年健康风险行为的循证干预(EBI)的传播。为此，拟议的研究将评估EBI实施支助战略，旨在促进经验验证的国家伙伴关系模式的更广泛传播，该模式有效地连接现有的EBI交付系统。关于青少年中的药物使用和其他危害健康的问题行为的流行病学数据，以及缺乏旨在预防此类问题的持续、高质量的EBI实施，表明有必要进行拟议的研究。成功和持续的EBI实施需要家庭、学校和社区之间的持续伙伴关系，并有一个积极主动的技术援助模式来支持他们。我们的Prosper伙伴关系模式将公立学校系统与被称为合作推广系统的土地赠款大学传播系统以及各州用于预防规划的其他资源联系起来。它经过了20年由美国国立卫生研究院资助的随机对照预防试验，并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方案传播系统提供的预防活动往往没有利用EBI，特别是那些以高质量和可持续的方式实施的EBI，因此有必要利用我们的模式接触到更多的州和社区。需要进一步开发和测试伙伴关系采用和执行支助部分。我们建议对来自所有50个州的代表土地赠与大学合作扩展、公共学校和公共卫生系统的关键信息者进行基于网络的调查，以评估可能影响采用Prosper伙伴关系模式的社会网络和准备因素，并将各州的准备程度排名为早期采用者(目标1)。使用州调查数据中的信息选择四个州，我们将对包含激励教练的伙伴关系采用决策团队支持战略进行评估(目标2)。最后，我们将在选定的伙伴关系就绪状态下对农村社区站点进行受控试点研究(目标3)。这将涉及提供Prosper模式培训和实施支助部分，以及新开发的基于网络的实施过程和成果评价系统。这项试点工作将使我们能够评估一系列影响EBI实施质量和EBI成果的系统和组织因素。它还将揭示，与相同州的社区网站相比，在没有我们的伙伴关系模式的情况下，繁荣社区网站是否显示出更高质量的EBI实施和更强的结果，这些社区网站进行的通常是由州和联邦资金支持的预防活动。 公共卫生相关性： 一直有有限的随机纵向研究评估如何以最佳方式维持循证干预(EBI)在普通人群中的高质量实施，以便在人群水平上对青少年吸烟、其他药物使用和其他问题行为(如攻击性)产生影响。调查人员在过去20年中进行的基于社区和大学伙伴关系的预防试验产生了一个经经验验证的模型，该模型支持高质量、可持续地实施一般人口EBI。过去的试点工作表明，承诺具体采用和实施支持在多个州地点更广泛地传播该模式(称为PROSPER网络模式)，将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.