Using community-based participatory research and qualitative methods to evaluate

描述（由申请人提供）：尽管研究人员早就认识到开发和评估干预措施的重要性，但为了评估项目结果，对实施过程的监测、项目的完整性常常被忽视。事实上，最近的一项综述发现，在六种主要心理学和精神病学期刊上发表的随机对照试验中，只有不到4%的试验充分解决了治疗的完整性问题（Perepletchikova et al., 2007）。此外，很少有研究考察了计划完整性与实际结果之间的关系（Dane & Schneider, 1998），尽管人们认为，以更高水平的完整性实施的计划应该与积极效果有关。更好地了解影响干预措施实施质量的因素，对于确定对成功至关重要的干预措施组成部分，以及监测干预措施实施的可行性和文化敏感性，具有极其重要的意义。

DESCRIPTION (provided by applicant): Although researchers have long recognized the importance of developing and evaluating interventions, the monitoring of the implementation process, program integrity, has often been neglected in favor of evaluating program outcomes. In fact, a recent review found that less 4% of randomized control trials published in six leading psychology and psychiatry journals adequately addressed treatment integrity (Perepletchikova et al., 2007). Further, very few studies have examined the relation between program integrity and actual outcomes (Dane & Schneider, 1998) despite the belief that programs implemented with higher levels of integrity should be associated with positive effects. Better understanding what factors contribute to the quality of intervention implementation are extremely important in identifying components of interventions that are critical for success and for monitoring the feasibility and cultural sensitivity of intervention delivery. With funding from NIH the Principal Investigator has developed a school-based integrity monitoring system through a participatory action research model, whereby best-practice, empirically-based strategies were adapted by obtaining key stakeholder feedback and input. This partnership-based research effort has resulted in an integrity monitoring observation system that assesses both therapist adherence and some aspects of the quality of intervention delivery (e.g., therapist competence and participant engagement). However, the current proposal seeks to extend this research by using a series of qualitative research strategies (e.g., focus groups, semi-structured interviews) to better understand additional understudied factors that may contribute to quality intervention delivery (e.g., therapeutic alliance, the therapist's ability to address important cultural issues) within the context of two community-based violence prevention programs being conducted within urban afterschool venues. In addition, we will also preliminarily evaluate how these factors may facilitate or hinder program success. PUBLIC HEALTH RELEVANCE (provided by applicant): Developing and implementing empirically-based and culturally-responsive violence prevention programs within urban after-school settings has the potential to positively impact a number of high risk youth and families. However, researchers and community members need to collaborate on the use of novel methods for better understanding the complex mix of factors that impact the quality of intervention delivery. Results from our study will be useful in uncovering how empirically-based intervention strategies can be optimally effective when conducted in an engaging and culturally-responsive manner.