Prevention of Young Adult Drug Use in Club Settings

描述（由申请人提供）：这是一项研究的更新（竞争延续），重点是在以电子音乐舞蹈活动（EMDEs）为特色的俱乐部环境中预防吸毒和相关危险行为。我们的第一项研究提供的证据表明，参加这类活动的吸毒者人数足够多，足以保证下一步的工作，即测试在俱乐部实施先前证明的环境预防策略的可行性。拟议的研究将实施和测试实施环境预防战略的可行性，这些战略旨在减少俱乐部中的吸毒和其他危险行为（例如，俱乐部中存在吸毒和吸毒者以及与毒品有关的和其他危险行为，如吸毒驾驶、过量用药、性冒险、攻击行为）。我们的具体目标如下：具体目标1：在扶轮社实施环境改变策略之前，衡量环境指标、主办政策和赞助人的特征和行为。具体目标2：在俱乐部实施环境干预措施，并评估和跟踪实施这些战略的可行性和实施的保真度。具体目标3：审查从干预前到干预后药物使用水平和药物相关风险的变化，并考虑到环境预防战略采用的变化。这项可行性研究将包括四个俱乐部，以检验环境预防战略。两个俱乐部将被随机分配在第二年开始时接受干预，而另外两个俱乐部将被要求等待额外的一年进行干预。这种改进的交叉设计将在我们的分析部分进行讨论。我们的数据收集时间框架包括5次主要的数据收集，大约间隔6个月，从干预前的基线测量开始。每个主要数据波将包括多个数据来源：俱乐部观察、主持人/工作人员访谈（每波20次访谈）和门户网站从顾客收集的数据（n=2000）。广告评估也将按月收取。对俱乐部的额外观察将在主要数据收集和广告评估之间进行，每月进行一次。从我们之前的研究中采取的措施以及一些额外的问题已经计划好了（例如，关于在实施环境战略中遇到的障碍的主持人和工作人员访谈）。因此，这种竞争性更新的总体设计建立在我们在之前的研究中测试过的措施（见附录）以及基于干预和我们从之前的工作中学到的知识（见下面的测量部分）实施新措施的基础上。提议的申请并不是一项功效研究，而是一项可行性研究，旨在测试俱乐部的环境策略是否可以实施，评估实施的障碍和障碍，并证明少数俱乐部的变化可以保证在随后的申请中对众多地点进行全面的功效研究。公共卫生相关性：该研究将测试以电子音乐舞蹈活动（EMDEs）为特色的俱乐部、吸毒和其他危险行为高发区的环境预防策略的可行性。与俱乐部老板、经理和员工合作，这种干预将检验策略是否能降低风险。这项研究的优势在于，它关注了年轻的在职成年人和大学生。此外，我们的初步工作表明，在这种情况下发现了个体的多样性。最后，研究小组与娱乐行业建立了良好的合作关系，使这项工作尤其及时。

DESCRIPTION (provided by applicant): This is a renewal (competing continuation) for a study that focuses on preventing drug use and related risky behavior in club settings that feature electronic music dance events (EMDEs). Our first study provided evidence that the number of drug users attending this type of event was sufficiently large to warrant the next step, i.e., to test the feasibility of implementing previously-proven environmental prevention strategies in clubs. The proposed study will implement and test the feasibility of implementing environmental prevention strategies designed to reduce drug use and other risky behaviors in clubs (e.g., presence of drug use and drug users in the clubs and drug-related and other risky behaviors such as drugged driving, overdoses, sexual risk-taking, aggressive behaviors). Our specific aims are as follows: Specific Aim 1: To measure environmental indicators, host policies, and patron characteristics and behaviors prior to implementing environmental change strategies in clubs. Specific Aim 2: To implement environmental interventions in the clubs and to assess and track the feasibility of implementing these strategies and fidelity of this implementation. Specific Aim 3: To examine the changes from pre- to post-intervention levels of drug use and drug related risks, accounting for the changes in the adoption of environmental prevention strategies. A total of four clubs will be included in this feasibility study to test the environmental prevention strategies. Two clubs will be randomly assigned to receive the intervention at the start of the second year, while the other two clubs will be required to wait an additional year for the intervention. This modified crossover design is discussed in our analyses section. Our data collection timeframe includes 5 major waves of data collection approximately six months apart and beginning with baseline measures prior to intervention. Each major data wave will include multiple sources of data: Observations of clubs, Host/staff interviews (20 interviews per wave) and Portal data collections from patrons (n=2000). Advertising assessments also will be collected monthly. Additional observations of clubs will occur halfway between the major data wave collection and advertising assessments will occur monthly. Measures from our prior studies as well as some additional questions are planned (e.g., host and staff interviews about barriers encountered in the implementation of environmental strategies). Hence, the overall design for this competitive renewal builds upon the measures we have tested in the prior studies (see appendices) as well as implementing new measures based upon the intervention and what we have learned from the prior work (see measurement section below). The proposed application is not an efficacy study, rather a feasibility study designed to test whether the environmental strategies for clubs can be implemented, to assess the barriers and impediments to the implementation and to demonstrate change within a small number of clubs that can warrant a full-scale efficacy study across numerous sites in a subsequent application. PUBLIC HEALTH RELEVANCE: The research will test the feasibility of environmental prevention strategies for clubs that feature electronic music dance events (EMDEs), locations having high rates of drug use and other risky behaviors. Working with club owners, managers, and staff, this intervention will test whether strategies to reduce risks. Strengths of the study include the focus on young working adults, as well as college students. Further, our initial work indicates that a diversity of individuals is found in this setting. Finally, the study team has developed excellent collaborative relationships with the entertainment industry making this effort especially timely.