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

点击翻译按钮获取中文摘要

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.