Native iCHAMPS: An Innovative Online Decision Support System for Increasing Implementation of Effective Sexual Health Education in Tribal Communities

Native iCHAMPS：一个创新的在线决策支持系统， 在部落社区开展有效的性健康教育 摘要 美洲印第安人和阿拉斯加原住民青年在性和生殖方面存在严重差距。 健康这些差异可以通过实施有效的性健康教育来改善。然而， 多种因素，如缺乏获得文化相关的循证干预措施（EBI）， 训练有素的人员、文化障碍和地理隔离，阻碍了 在部落社区开展有效的性健康EBI。这项R21研究的目标是适应和评估 一个创新的在线决策支持系统（DSS）的可行性，本地iCHAMPS，作为一个有效的 促进在AIAN采用和实施性健康EBI的实施战略 社区.我们建议调整iCHAMPSS（选择和维持有效的性方案）， 学校教育），这是一个基于理论的在线DSS，由我们的研究团队开发，以增加吸收和 在德克萨斯州的学校实施性健康EBI。立足于传播和执行（D&I） iCHAMPSS包含60多种工具，为克服D&I障碍提供分步指导， 性健康教育。显示影响EBI采用和实施的关键决定因素， 动员学校工作人员获得董事会的批准，并实施性健康EBI，iCHAMPSS作为 一个很好的实施战略，以适应AIAN社区。AIAN利益相关者（n=35）评级 iCHAMPSS是可接受的、易于使用的、可信的、有吸引力的，并且比当前的EBI资源更有帮助 在AIAN社区采用和实施。然而，由于iCHAMPSS是专为 德克萨斯州的学校，基本的DI&过程可能无法充分反映AIAN社区的D&I过程。 事实上，人工智能网络利益攸关方建议对iCHAMPSS进行调整，以更好地反映 部落社区。我们的长期目标是减少青少年怀孕，艾滋病毒/艾滋病在AIAN青年，增加 在AIAN社区采用、实施和维护与文化相关的性健康EBI。 在这项R21研究中，我们建议调整现有的iCHAMPSS概念模型和DSS，以解决障碍 以及在AIAN中采用、实施和维持性健康教育EBI的促进者 社区（本土iCHAMPS），确定战略，以优化其采用和实施，并评估 在一个异构的样本中采用和实施本机iCHAMPS的可行性和影响 和地理上不同的AIAN利益相关者（n=45）在美国的研究是创新的，因为它通知了一个 AIAN社区性健康EBI的文化相关的概念性D&I模型，并将其转化为 模型作为一个实用的跨平台数字DSS（本地iCHAMPS），以增加D&I能力，在地理上 与世隔绝的、资源匮乏的AIAN社区这是重要的，因为它促进了文化相关的使用， 性健康EBI，从而影响人口健康的服务不足，高风险AIAN青年。发现将 通知随机多站点R 01试验，以评估土著iCHAMPS在AIAN社区的有效性。

Native iCHAMPS: An Innovative Online Decision Support System for Increasing Implementation of Effective Sexual Health Education in Tribal Communities ABSTRACT American Indian and Alaska Native (AIAN) youth experience serious disparities in sexual and reproductive health. These disparities may be ameliorated by the implementation of effective sexual health education. Yet, multiple factors, such as lack of access to culturally-relevant evidence-based interventions (EBIs), limited trained personnel, cultural barriers, and geographic isolation, hinder the adoption and implementation of effective sexual health EBIs in tribal communities. The goal of this R21 study is to adapt and assess the feasibility of an innovative online decision support system (DSS), Native iCHAMPS, as an effective implementation strategy to facilitate the adoption and implementation of sexual health EBIs in AIAN communities. We propose to adapt iCHAMPSS (CHoosing And Maintaining Effective Programs for Sex Education in Schools), a theory-based, online DSS developed by our research team to increase uptake and implementation of sexual health EBIs in Texas schools. Grounded in dissemination and implementation (D&I) theories, iCHAMPSS comprises 60+ tools to provide step-by-step guidance to overcome D&I barriers for sexual health education. Shown to impact critical determinants of EBI adoption and implementation and to mobilize school personnel to obtain board approval and implement a sexual health EBI, iCHAMPSS serves as an excellent implementation strategy to adapt for AIAN communities. AIAN stakeholders (n=35) rated iCHAMPSS as acceptable, easy to use, credible, appealing, and more helpful than current resources for EBI adoption and implementation in AIAN communities. Yet, because iCHAMPSS was designed specifically for Texas schools, the underlying DI& processes may not adequately reflect D&I processes in AIAN communities. Indeed, AIAN stakeholders recommended adaptations to iCHAMPSS to better reflect the needs and values of tribal communities. Our long-term goal is to reduce teen pregnancy, STI/HIV among AIAN youth by increasing the adoption, implementation, and maintenance of culturally-relevant sexual health EBIs in AIAN communities. In this R21 study, we propose to adapt the existing iCHAMPSS conceptual model and DSS to address barriers and facilitators to the adoption, implementation, and maintenance of sexual health education EBIs in AIAN communities (Native iCHAMPS), identify strategies to optimize its adoption and implementation, and assess the feasibility and impact of adopting and implementing Native iCHAMPS among a sample of heterogeneous and geographically disparate AIAN stakeholders (n=45) across the U.S. The study is innovative as it informs a culturally relevant, conceptual D&I model for sexual health EBIs in AIAN communities, and translates that model as a practical cross-platform digital DSS (Native iCHAMPS) to increase D&I capacity in geographically isolated, low-resource AIAN communities. It is significant because it advances use of culturally-relevant sexual health EBIs, thus impacting population health for underserved, high-risk AIAN youth. Findings will inform a randomized multisite R01 trial to assess the effectiveness of Native iCHAMPS in AIAN communities.