Enhancing the Impact of Evidence-Based Prevention for Youth: The Rapid Adaption to Prevent Drug Use (RAPD) Implementation Strategy

增强青少年循证预防的影响：快速适应预防吸毒 (RAPD) 实施策略

• 批准号: 10673882
• 负责人: Andria B Eisman
• 金额: $ 23.1万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673882
• 关键词: Address; Adolescent; Adopted; Attention; COVID-19; Communities; Cost Analysis; Costs and Benefits; Data; Disparity; Drug usage; Early Intervention; Educational Curriculum; Effectiveness; Equity; Event; Evidence based intervention; Family; Foundations; Future; Goals; Health; Health behavior; Health education; Health system; Health trends; Hybrids; Inequity; Infrastructure; Intervention; Low income; Methods; Michigan; Modeling; Morbidity - disease rate; Outcome; Pharmaceutical Preparations; Phase; Population; Poverty; Prevention; Process; Public Health; Recording of previous events; Reporting; Research; Research Proposals; Resources; Risk; Schools; Shapes; Societies; Students; Substance Use Disorder; Support System; System; Testing; Training; Trauma; Update; Youth; academic standard; comparative; coronavirus disease; cost; cost effectiveness; design; drug abuse prevention; drug misuse; drug standard; economic evaluation; evidence base; implementation evaluation; implementation outcomes; implementation science; implementation strategy; improved; innovation; marginalization; mortality; multiple drug use; novel; novel therapeutics; pilot test; programs; rapid test; rapid testing; response; risk perception; skills; stakeholder perspectives; stem; teacher; trend; vaping

Drug use trends change rapidly among youth, leaving intervention experts struggling to respond to emerging drugs promptly. We have a critical need to advance implementation strategies to optimize system responsiveness to these emerging issues. COVID-19 has increased the urgency for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts. Tier 1 evidence-based interventions (EBIs), such as the Michigan Model for HealthTM (MMH) lend themselves to addressing emerging trends. Our overall objectives are to 1) Improve the responsiveness of school-based EBIs in addressing urgent issues and 2) Find ways to support teachers in implementing updated EBIs, attending to unique considerations of low-resource schools. We will use After Action Review (AAR), to guide the systematic design of RAPD, Rapid Adaptation to Prevent Drug use, a novel bundle of implementation strategies. AAR is a reflective process focused on improving public health systems’ rapid response capacity. Key phases of AAR include: 1) Objective observation; 2) Analyze gaps/best practices, 3) Identify and test suitable implementation strategies to improve responsiveness to the next event (e.g., COVID-related drug use escalation). Sustainable strategies are central to achieving our objectives. Thus, we will also conduct a preliminary stakeholder-focused cost analysis. The rationale for this research is that designing and testing RAPD will enhance schools’ capacity to respond to urgent drug issues sustainably, and provide up-to-date, relevant resources for effective and equitable prevention. The proposed research will address the following aims: Aim 1: Identify implementation gaps and best practices in responding to urgent drug use events. We will use AAR to review the statewide response to the vaping crisis using the MMH using rapid qualitative analysis and identify gaps to be addressed with RAPD. Aim 2: Design and pilot test RAPD implementation and effectiveness. We will design a RAPD to optimize responses to urgent drug use events and pilot test in schools serving low-income students to assess equity. We will assess implementation outcomes using a convergent mixed methods design, and effectiveness via a group RCT comparing RAPD and standard MMH implementation. Aim 3: Assess costs and benefits of RAPD from multiple stakeholder perspectives. We will use an exploratory sequential mixed methods design to understand and identify key costs and outcomes from key stakeholder perspectives. We will develop a costing guide and conduct a preliminary cost analysis to inform an economic evaluation for a larger trial. The proposed research is innovative because to date implementation strategies have not been designed to support systems in responding to changing public health trends with attention to equity. In addition, this study focuses on implementation strategies to reduce the health impact of emerging drugs and provide an infrastructure to make future adaptations that can be applied in other contexts. The proposed research is significant because it will advance applying implementation science to achieve access, cost and equity for drug use prevention.

青少年吸毒趋势迅速变化，导致干预专家难以应对新出现的药物使用趋势 及时用药。我们迫切需要推进实施策略以优化系统 对这些新出现的问题的反应。 COVID-19 增加了实施科学的紧迫性 利用现有的治疗和预防工作促进快速、公平的应对措施。 1 级循证 密歇根健康模型 (MMH) 等干预措施 (EBI) 有助于解决新兴问题 趋势。我们的总体目标是 1) 提高校本 EBI 解决紧急问题的响应能力 2) 找到支持教师实施更新的 EBI 的方法，同时考虑到独特的因素 资源匮乏的学校。我们将使用事后审查（AAR）来指导RAPD的系统设计， 快速适应预防吸毒，一套新颖的实施策略。 AAR 是一种反射 过程的重点是提高公共卫生系统的快速反应能力。 AAR 的关键阶段包括：1) 客观观察； 2) 分析差距/最佳实践，3) 确定并测试合适的实施策略 提高对下一个事件的响应能力（例如，与新冠病毒相关的药物使用升级）。可持续战略 是实现我们目标的核心。因此，我们还将进行初步的以利益相关者为中心的成本 分析。这项研究的基本原理是，设计和测试 RAPD 将增强学校的能力 可持续地应对紧迫的毒品问题，并提供最新的相关资源，以有效和 公平的预防。拟议的研究将实现以下目标： 目标 1：确定实施情况 应对紧急吸毒事件的差距和最佳做法。我们将使用 AAR 来审查全州范围内的 使用 MMH 进行快速定性分析来应对电子烟危机，并确定需要解决的差距 与 RAPD。目标 2：设计并试点测试 RAPD 的实施和有效性。我们将设计一个 RAPD 优化对紧急吸毒事件的应对措施，并在为低收入学生服务的学校进行试点测试以评估 公平。我们将使用收敛混合方法设计来评估实施结果和有效性 通过比较 RAPD 和标准 MMH 实施的小组 RCT。目标 3：评估成本和收益 从多个利益相关者的角度来看 RAPD。我们将使用探索性顺序混合方法设计来 从关键利益相关者的角度理解并确定关键成本和结果。我们将制定成本核算 指导并进行初步成本分析，为更大规模试验的经济评估提供信息。拟议的 研究具有创新性，因为迄今为止实施策略尚未设计为支持系统 应对不断变化的公共卫生趋势，注重公平。此外，本研究重点关注 减少新兴药物对健康影响的实施战略并提供基础设施 未来的调整可以应用于其他情况。拟议的研究意义重大，因为它将 推进应用实施科学，以实现预防吸毒的机会、成本和公平。