The Impact of Adaptation on Successful Implementation

摘要在20世纪80年代和90年代期间，药物滥用预防研究的重点是确定可被证明有效阻止酒精、烟草、大麻、吸入剂和其他形式的药物使用的干预措施的组成部分。在此期间，所提出的问题从“预防是否有效？”演变为“如何通过方案的设计使方案更有效？”随着美国教育部有效性原则的出台和SAMHSA国家有效项目和实践登记处（NREPP）的建立，以及相应的政策转变，促进了对学校和社区团体中基于证据的项目的资助，已经出现了明显的从研究到证明有效性的转变。拟议研究的目标是了解实施者如何适应全明星计划。全明星计划是一项基于研究的计划，已被48个州、维尔京群岛和波多黎各的250多所学校和社区服务机构采用。本研究的总体目标是依次回答三个问题：(1)全明星队的实施者在多大程度上以及为什么修改了书面计划？(2)修改如何影响目标中介和结果变量？(3)旨在促进积极改变的干预措施是否能改善结果？目前的项目将解决问题(1)和(2)，为后续的拨款申请做准备，该申请将致力于解决问题(3)。将进行两项次级研究。子研究1的目标是定义实现者在实现All Stars时如何以及为什么修改它。通过回顾从以前的研究项目中收集的录像带以及进行调查、观察和对潜在实施者的访谈，将检查计划内和计划外的修改。调整将被记录下来，并探讨这些修改的基本原理。子研究1将导致数据收集工具的开发，这些工具将在子研究2中使用。子研究2的目标将是从大量已经使用全明星的传播网站收集广泛的适应性数据，以确定在改变项目和青少年吸毒的中介变量方面，各种类型的适应性是增强、中性效果还是削弱项目有效性的程度。研究结果将用于一项后续研究，在这项研究中，将制定制定方案以促进积极适应和满足执行者需要的战略，并在一项随机对照试验中加以检验。药物使用，包括使用酒精、烟草、大麻、吸入剂和非法药物，仍然是全国的一个问题。许多以研究为基础的预防方案现已在全国推广。这个项目将检查学校和社区服务机构是如何采用一个药物使用预防计划，全明星，对学生实施该计划，他们如何以及为什么要适应该计划，以及适应对成功实现该计划目标的影响。

DESCRIPTION (provided by applicant): The Impact of Adaptation on Successful Implementation Abstract During the period encompassed by the 1980s and 1990s, the focus on drug abuse prevention research was to identify components of intervention that could be demonstrated to be efficacious in deterring the onset of alcohol, tobacco, marijuana, inhalants, and other forms of drug use. During this period, the question asked evolved from "Can prevention work?" to become "What can make programs more efficacious through how programs are designed?" With the advent of the US Department of Education's Principles of Effectiveness and the establishment of SAMHSA's National Registry of Effective Programs and Practices (NREPP) and a corresponding shift in policy that promoted funding for evidence-based programs in schools and community groups, there has been a noticeable shift away from research to demonstrate efficacy. The goal of the proposed research is to understand how implementers adapt All Stars, a research-based program that has been adopted by more than 250 schools and community service agencies in 48 states, the Virgin Islands, and Puerto Rico. The overall goal of this research is to answer three questions in sequence: (1) to what extent and why do All Stars' implementers modify the program as written? (2) How do modifications affect targeted mediators and outcome variables? (3) Does an intervention designed to promote positive modifications improve outcomes? The current project will address questions (1) and (2) in preparation for a subsequent grant application that will be devoted to addressing question (3). Two sub-studies will be conducted. The goal of Sub-Study 1 is to define how and why implementers modify All Stars when it is implemented. Both planned and unplanned modifications will be examined by reviewing videotapes collected from a previous research project as well as by conducting surveys, observations, and interviews with prospective implementers. Adaptations will be documented and the rationale for these modifications explored. Sub-Study 1 will result in the development of data collection tools that will be used in Sub-Study 2. The goal of Sub-Study 2 will be to collect extensive data about adaptation from a large number of dissemination sites} clients already using All Stars } to determine the degree to which various types of adaptations either augment, have a neutral effect, or diminish the effectiveness of the program in terms of changing mediating variables targeted by the program and adolescents' drug use. Results will be used in a follow-up study in which strategies for developing programming to promote positive adaptation and to meet implementers' needs will be developed and tested in a randomized control trial. Project Narrative Drug use, including the use of alcohol, tobacco, marijuana, inhalants, and illicit drugs continues to be a problem throughout the nation. Numerous research-based prevention programs are now disseminated throughout the country. This project will examine how schools and community service agencies that have adopted one drug use prevention program, All Stars, implement the program to students, how and why they make adaptations to the program, and what effect making adaptations has on successfully achieving the program's goals.