Implementation Support for Prevention Program Delivery by College PeerEducators

大学同伴教育者对预防计划实施的实施支持

基本信息

批准号：
10302308
负责人：
ERIC M STICE
金额：
$ 53.66万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-12-15 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10302308
关键词：
Address Adoption Caring Characteristics Clinic Communication Competence Consolidated Framework for Implementation Research Cost Savings Counseling Data Eating Disorders Education Educational workshop Effectiveness Female Future Goals Individual Institute of Medicine (U.S.)Intervention Knowledge Leadership Measures Mental Depression Mental Health Mental disorders Methods Monitor National Research Council Outcome Participant Population Positioning Attribute Prevalence Prevention Prevention program Procedures Process Program Effectiveness Program Sustainability Randomized Services Speed Structure Students Substance abuse problem Surveys Testing Trainers Training Training Training Support Universities Waiting Lists base college cost cost effective cost effectiveness effective intervention evidence base experience follow-up group intervention high risk implementation outcomes implementation strategy indexing innovation intervention delivery peer peer support programs quality assurance recruit relative cost research to practice response skills treatment as usual university student web site young adult

项目摘要

ABSTRACT Several interventions for mental health problems are efficacious and effective, but few are routinely offered to college students, who represent 59% of young adults. This is regrettable because college students are at high risk for mental health problems (e.g., depression, substance abuse, eating disorders), and college counseling centers lack sufficient clinicians to offer individual therapy to all afflicted students and are not well positioned to deliver prevention programs. One solution for this service shortfall is to have peer educators deliver scripted group-based prevention programs, which can more efficiently reduce the burden of mental illness than individual therapy. Targeting college students is a cost-effective tactic for delivering prevention programs and has vast potential reach because 85% of colleges have peer educator programs. Peer educators have effectively delivered several prevention programs, sometimes producing larger effects than clinicians, as was the case in a preliminary trial of a group-based prevention program with a particularly strong evidence-base. Guided by Wandersman et al. (2012), we propose to evaluate 3 levels of implementation support (training, technical assistance, and quality assurance/improvement) for the delivery of a prevention program. We will randomize 45 colleges to: (1) a Training condition where experts provide an intensive discrete 2-day initial train-the-trainer workshop that simultaneously trains peer educators to deliver the intervention and campus supervisors to train and support future peer educators, plus the facilitator guide and facilitator support website; (2) a Training + Technical Assistance condition, adding a ½ day implementation training to articulate goals, needs, leadership structure, adoption options, recruitment strategies, and communication; or (3) a Training + Technical Assistance + Quality Assurance/Quality Improvement condition adding 1 year of technical assistance, coaching, and quality assurance to enhance implementation skills and sustainability. We will test whether greater implementation support is associated with graded increases in fidelity and competence in delivering the scripted prevention program (Aim 1), student attendance of the intervention and effectiveness of the program on pre-to-post changes in outcomes compared to usual care data collected before implementation (Aim 2), and reach and sustainability of the program (Aim 3). We will test whether Consolidated Framework for Implementation Research (CFIR) indices of perceived intervention characteristics, outer and inner setting factors, peer educator attributes, and process factors after the initial training correlate with fidelity, competence, attendance, effectiveness, reach, and sustainability over the implementation period and test whether at the end of the initial 1-year implementation period the 3 conditions differ on relevant CFIR indices and on the progress and timing of implementation (Aim 4). We will evaluate the prevention program delivery cost in the 3 conditions and the relative cost-effectiveness of each condition in terms of attaining intervention fidelity, competence, attendance, effectiveness, reach, and sustainability, as well as general cost-savings at the clinics (Aim 5).

抽象的关于心理健康问题的几种干预措施效率有效，但很少有人提供大学生，代表59％的年轻人。这是值得致敬的，因为大学生很高心理健康问题的风险（例如抑郁症，药物滥用，饮食失调）和大学咨询中心缺乏足够的临床医生，无法为所有受苦的学生提供个人治疗，并且没有很好的位置提供预防计划。这项服务短缺的一种解决方案是让同伴教育工作者交付脚本基于团体的预防计划，可以更有效地减少精神疾病的燃烧个人疗法。针对大学生是提供预防计划的经济效率的策略，由于有85％的大学拥有同伴教育计划，因此具有巨大的潜在影响力。同伴教育者有有效地提供了几个预防计划，有时会产生比临床医生更大的效果，该案在基于组的预防计划的初步试验中，具有特别强大的证据库。由Wandersman等人指导。（2012年），我们建议评估3个实施支持级别（培训，提供预防计划的技术援助和质量保证/改进）。我们将随机将45所大学随机化：（1）专家提供密集的离散2天初始初始的培训条件训练培训训练研讨会，只需培训同伴教育者即可提供干预和校园主管培训和支持未来的同伴教育者，以及主持人指南和协调员支持网站；（2）培训 +技术援助条件，增加了½天的实施培训以阐明目标，需求，领导结构，采用选择，招聘策略和沟通；或（3）培训 + 技术援助 +质量保证/质量改进条件增加了1年的技术协助，指导和质量保证，以增强实施技能和可持续性。我们将测试更大的实施支持是否与忠诚度和能力的分级提高有关提供脚本预防计划（AIM 1），学生参加干预和有效性与在实施之前收集的常规护理数据相比，有关结果的前后变化计划（AIM 2），以及该计划的达到和可持续性（AIM 3）。我们将测试是否合并框架感知干预特征，外部和内部环境的实施研究（CFIR）指数初始培训后的因素，同伴教育属性和过程因素与忠诚，能力，在实施期内出席，有效性，覆盖范围和可持续性，并测试是否最终在最初的1年实施期内，相关CFIR指数和进度的3个条件不同和实施时间（目标4）。我们将在3个条件下评估预防计划的交付成本以及每种条件的相对成本效益，以达到干预忠诚，能力，出勤，有效性，影响力和可持续性以及诊所的一般成本节省（AIM 5）。