Ehancing Prevention Capacity with Developmental Assets and Getting to Outcomes

描述（由申请人提供）：酒精和药物（AOD）的使用在许多社区是有问题的。尽管循证预防得到推广，但社区在实现预防科学所证明的成果方面仍然面临困难。这一“差距”是因为资源有限，预防工作复杂，社区往往缺乏适应和执行“现成”方案的能力。此外，许多以证据为基础的方案旨在改善赤字-尽管有证据表明还需要通过全社区的努力促进青年的积极发展。弥补这一差距的常用方法，如信息传播，未能改变地方一级的做法或结果，部分原因是它没有充分解决能力问题或利用社区投入。因此，通过加强科学家和从业人员之间的合作，建设社区的预防能力，重点关注青年的积极发展，是一种可以提高预防质量和成果的方法。本项目将评估专门为促进这种方法而设计的两种模式的组合：取得成果和发展资产。它们是相辅相成的：地球静止轨道组织增强了地方执行个别预防任务的能力（例如，发展资产支持社区动员和协作，以促进青年的积极发展。结合这两个SAMHSA（最佳做法）预防规划过程的内容，工具和资源有可能提高预防方案编制和问责制的质量，而不是单独进行。资产和GTO的准实验和案例研究表明，在社区环境中是可行的，并产生了证据，表明这些模式可以帮助社区动员和改善预防做法和成果。作为下一步，我们提出了一个随机对照有效性试验的有效性研究的元素（即，在以社区为基础的环境中实施），比较了6个使用资产-GTO的AOD预防联盟和6个没有使用的类似联盟。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。我们将采用参与式研究方法，其中联盟代表工作组将积极参与研究的所有阶段。将在方案一级（每个联盟5个）通过与工作人员面谈，在个人一级通过联盟调查（每个联盟约有54名成员），评估资产-地球静止轨道组织对预防能力的影响。对联盟运作的学校进行的一项调查将评估对AOD使用的影响和方案目标人群的积极发展成果。组织变革理论将指导资产-GTO的实施;标准化措施将跟踪资产-GTO的采用。研究结果将影响到如何确保通过研究试验发现有效的预防方案在真实的世界环境中成功实施，这是NIDA和NIAAA的一个优先事项。项目叙述本提案中概述的预防酒精和药物使用（AOD）的资产取得成果系统的演示和评估与公共卫生直接相关。这是因为青少年使用AOD是美国社区面临的一个重大健康问题。资产-取得成果系统旨在帮助参与AOD预防工作的社区更好地规划、实施和自我评估其预防战略，以帮助他们取得积极成果，从而对地方一级的青年死亡率和发病率产生积极影响。公共卫生相关性：本提案中概述的预防酒精和毒品使用的资产取得成果系统的示范和评估与公共卫生直接相关。这是因为青少年使用AOD是美国社区面临的一个重大健康问题。资产-取得成果系统旨在帮助参与AOD预防工作的社区更好地规划、实施和自我评估其预防战略，以帮助他们取得积极成果，从而对地方一级的青年死亡率和发病率产生积极影响。

DESCRIPTION (provided by applicant): Alcohol and drug (AOD) use is problematic in many communities. Despite the spread of evidence-based prevention, communities still face difficulty in achieving outcomes demonstrated by prevention science. This "gap" is because resources are limited, prevention is complex, and communities often lack the capacity to adapt and implement "off the shelf" programs. Also, many evidence-based programs aim to improve deficits-- despite evidence showing the need to also promote positive youth development through community-wide efforts. Common ways to bridge this gap, such as information dissemination, fail to change practice or outcomes at the local level in part because it does not sufficiently address capacity or use community input. Therefore, building a community's prevention capacity, through greater collaboration between scientists and practitioners, with a focus on positive youth development, is a method that could improve the quality of prevention and outcomes. This project will assess the combination of two models that are specifically designed to foster such an approach: Getting To Outcomes (GTO) and Developmental Assets. They are complimentary: GTO enhances local capacity for discrete prevention tasks (e.g., evaluation); Developmental Assets supports community mobilization and collaboration to promote positive youth development. Combining the content, tools, and resources of these two SAMHSA (Best Practice) prevention planning processes has the potential to improve the quality of prevention programming and accountability more than either would do alone. Quasi - experimental and case studies of both Assets and GTO have demonstrated feasibility in community settings and yielded evidence suggesting these models can help communities mobilize and improve prevention practices and outcomes. As a next step, we propose a randomized controlled efficacy trial with elements of an effectiveness study (i.e., implementation in community-based setting) comparing 6 AOD prevention coalitions using Assets-GTO with 6 similar coalitions who are not. Such blended designs that emphasize generalizability and external validity are now recommended for community-based research. We will use a participatory research approach in which a Workgroup of coalition representatives will be actively involved in all phases of the research. Assets-GTO's impact on prevention capacity will be assessed at the program level (5 per coalition) with staff interviews and at the individual level with a Coalition Survey (each has about 54 members). A survey of schools in which the coalitions operate will assess the impact on AOD use and positive developmental outcomes among the programs' target populations. Organizational change theories will guide Assets-GTO implementation; standardized measures will track Assets-GTO adoption. Results will have implications for how to ensure that prevention programming found to be effective through research trials is successfully delivered in real world settings, a priority for NIDA and NIAAA. Project Narrative The demonstration and evaluation of the Assets-Getting To Outcomes system for the prevention of alcohol and drug (AOD) use outlined in this proposal has direct relevance to public health. This is because AOD use among youth is a significant health problem facing US communities. The Assets-Getting To Outcomes system is designed to help communities engaged in AOD prevention work to better plan, implement, and self-evaluate their prevention strategies in order to help them achieve positive results, thereby positively impacting the mortality and morbidity of youth at the local level. PUBLIC HEALTH RELEVANCE: The demonstration and evaluation of the Assets-Getting to Outcomes system for the prevention of alcohol and drug (AOD) use outlined in this proposal has direct relevance to public health. This is because AOD use among youth is a significant health problem facing US communities. The Assets-Getting To Outcomes system is designed to help communities engaged in AOD prevention work to better plan, implement, and self-evaluate their prevention strategies in order to help them achieve positive results, thereby positively impacting the mortality and morbidity of youth at the local level.