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

Native iCHAMPS：一种创新的在线决策支持系统，用于在部落社区加强有效的性健康教育的实施

• 批准号: 10092216
• 负责人: Christine Margaret Markham
• 金额: $ 19.4万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092216
• 关键词: Address; Adopted; Adoption; Alaska Native; American Indians; Area; Arizona; Attitude; Birth Rate; Communities; Decision Support Systems; Development; Dissemination and Implementation; Education; Educational Intervention; Effectiveness; Ethnic group; Evidence based intervention; Geography; Goals; HIV; HIV Infections; Health; Health Educators; Health Promotion; Health education; Human Resources; Individual; Internet; Knowledge; Logistics; Maintenance; Modeling; Organizational Policy; Population; Pregnancy in Adolescence; Prevention education; Process; Randomized; Randomized Controlled Trials; Readiness; Reproductive Health; Research; Resources; Sampling; Schools; Self Efficacy; Sex Education; Sexual Health; Sexually Transmitted Diseases; Site; Texas; Training; Translating; Tribal Council; Universities; base; design; digital; disparity reduction; effectiveness evaluation; experience; health disparity; high risk; implementation barriers; implementation process; implementation strategy; innovation; intervention mapping; native youth; population health; pregnancy prevention; programs; racial and ethnic; teen birth; theories; tool; tribal community; tribal health; uptake; usability

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.

Native iCHAMPS：一个创新的在线决策支持系统 在部落社区实施有效的性健康教育 摘要 美国印第安人和阿拉斯加原住民(AIAN)的年轻人在性和生殖方面存在严重差异 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，如缺乏获得与文化相关的循证干预措施的机会，受到限制 受过培训的人员、文化障碍和地理隔离阻碍了采用和实施 部落社区中有效的性健康EBI。本R21研究的目标是适应和评估 创新的在线决策支持系统(DSS)Native iCHAMPS作为一种有效的 促进AIAN采用和执行性健康EBIs的实施战略 社区。我们建议采用iCHAMPSS(选择和维持有效的性方案 学校教育)，这是我们的研究团队开发的一个基于理论的在线决策支持系统，旨在增加对 得克萨斯州学校性健康EBIS的实施。立足于传播和实施(D&I) 理论上，iCHAMPSS包括60多个工具，提供循序渐进的指导，以克服D&I障碍 性健康教育。显示影响采用和实施EBI的关键决定因素，以及 动员学校人员获得董事会批准并执行性健康EBI，iCHAMPSS充当 适用于AIAN社区的优秀实施战略。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社区中采用和实施。然而，因为iCHAMPSS是专门为 在德克萨斯州的学校，潜在的DI和流程可能不能充分反映AIAN社区的D&I流程。 事实上，AIAN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，减少AIAN青年中的STI/HIV 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采用、实施和维持性健康教育EBI的促进者 社区(原生iCHAMP)，确定优化其采用和实施的战略，并评估 在异质样本中采用和实施原生iCHAMPS的可行性和影响 和地理位置不同的AIAN利益相关者(n=45)。这项研究具有创新性，因为它向 AIAN社区中性健康EBI的与文化相关的概念性D&I模型，并翻译为 作为一个实用的跨平台数字决策支持系统(Native ICHAMPS)的模型，以增加地理上的D&I能力 与世隔绝、资源匮乏的AIAN社区。它之所以意义重大，是因为它促进了与文化相关的 性健康EBIs，从而影响服务不足的高危AIAN青年的人口健康。调查结果将 通知一项随机多点R01试验，以评估AIAN社区中原生iCHAMPS的有效性。

项目成果

The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping to adapt an online decision support system to promote culturally-relevant sexual health education for American Indian and Alaska Native youth.

• DOI: 10.3389/fpubh.2022.889924
• 发表时间: 2022
• 期刊: Frontiers in public health
• 影响因子: 5.2
• 作者: Markham CM;Rushing SC;Manthei J;Singer M;Jessen C;Gorman G;Peskin MF;Hernandez BF;Sacca L;Evans GS;Luna-Meza C;Merritt Z;Shegog R
• 通讯作者: Shegog R

Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in indigenous communities: a scoping review.

• DOI: 10.1186/s13012-022-01190-y
• 发表时间: 2022-02-21
• 期刊: Implementation science : IS
• 作者: Sacca L;Shegog R;Hernandez B;Peskin M;Rushing SC;Jessen C;Lane T;Markham C
• 通讯作者: Markham C