Implementing Fourth R in US schools: feasibility, fidelity, and sustainability

在美国学校实施 Fourth R：可行性、保真度和可持续性

• 批准号: 9035127
• 负责人: Jeff R Temple
• 金额: $ 34.29万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9035127
• 关键词: Implementing; Fourth; US; schools; feasibility

 DESCRIPTION (provided by applicant): Each year, approximately 25% of US teens sustain physical, psychological, or sexual abuse by dating partners. Many victims of teen dating violence (TDV) experience a host of devastating consequences, including acute and chronic mental and physical health problems, suicidality, delinquency, risky sexual behavior, substance abuse, and academic failure. Moreover, perpetrators of TDV are more likely to perpetrate other forms of violence and are at increased risk for continuing intimate partner violence in adulthood. Although TDV is a pervasive problem, it is largely preventable. One efficacious program, the Fourth R, integrates the promotion of healthy relationship skills and prevention of TDV into existing school curricula. Fourth R components are aligned with state and federal curriculum requirements in health, thus minimizing time and financial burdens placed upon resource-strapped schools. It includes both classroom activities and school-level components in which teachers receive specialized training on teaching about healthy relationships and students form "safe school committees." Fourth R is used in over 5,000 schools in Canada, as well as several sites throughout the United States and Europe, and multiple systematic reviews and national agencies have identified it as one of only a few promising TDV prevention programs. Indeed, Fourth R has been shown to reduce physical TDV perpetration, increase relationship and peer resistance skills, and increase condom use. The effectiveness of Fourth R has been especially pronounced among high-risk youth. Developing an efficacious prevention program such as the Fourth R is only part of the equation. Implementing the program in real-world settings with fidelity and sustainability is the other, perhaps more difficult, part. Thus, prior to the Fourth R undergoing widespread dissemination and implementation, it is crucial to understand how factors at the school, teacher, and student levels affect program feasibility, fidelity, and sustainability. Also of interest is how this Canadian program is translated and adapted for use in US urban, suburban, and rural high schools. We propose to train teachers to implement Fourth R with 4 successive cohorts of 9th-grade students in 10 ethnically, economically, and geographically diverse high schools in Texas. The primary aims of this implementation study, which will use a mixed methods design, are to (1) assess initial feasibility, quality, acceptabilit, engagement, adaptation, and satisfaction with Fourth R, (2) examine school-, teacher-, and student-level barriers to high-fidelity implementation and correlates of low fidelity to the intervention protocol, (3) determine sustainability and impact of experience on implementation by assessing changes over the course of the study in fidelity, feasibility, acceptability, satisfaction, and engagement, and (4) evaluate effects of initial implementation fidelity and change over time on students' changes in attitudes, knowledge, skills, intentions, and behavior related to teen dating violence.

 描述（由适用提供）：每年约25％的美国青少年通过约会伴侣维持身体，心理或性虐待。青少年约会暴力（TDV）的许多惊喜经历了许多毁灭性的后果，包括急性和慢性心理和身体健康问题，自杀，犯罪，危险的性行为，滥用药物和学术失败。此外，尽管TDV是一个普遍的问题，但TDV的肇事者比这是可以预防的。一个有效的计划，即第四R，将健康关系技能的促进和预防TDV纳入了现有的学校课程。第四个r组成部分与州和联邦的健康课程要求一致，从而最大程度地减少了时间和金融伯恩斯在资源短缺的学校上。它包括课堂活动和学校级别的组成部分，教师接受有关健康关系和学生组成的“安全学校委员会”的专门培训。第四r在加拿大的5,000多所学校以及美国和欧洲的几个地点中使用，多个系统的审查和国家机构已将其确定为仅有的少数承诺的预防TDV计划之一。实际上，已经证明第四个R可以减少物理TDV的持续性，提高关系和同行抵抗能力，并增加使用安全套的使用。在高风险青年中，第四r的有效性尤其明显。制定有效的预防程序（例如第四r）只是方程的一部分。在具有忠诚和可持续性的现实环境中实施该计划是另一个，也许更困难的一部分。那是在第四次r之前 经过广泛的传播和实施，了解学校，教师和学生级别的因素如何影响计划的可行性，忠诚和可持续性至关重要。同样令人感兴趣的是，该加拿大计划是如何被翻译和调整的，以用于美国城市，郊区和大致高中。我们建议培训教师在德克萨斯州的10个种族，经济和地理上多样化的高中，在10个9年级的学生中实施第四次R。这项实施研究的主要目的（将使用混合方法设计）是（1）评估初始可行性，质量，可接受性，参与性，适应性，适应和满意度以及第四r，（2）考试学校，（2）学院，教师和学生级别的障碍，对高保真实施的障碍，通过评估低忠诚度的实施和对实施的实施和影响的实施，（3）确定的实施，（3）确定的实施，（3），（3）确定的实施，（3），（3）确定的实施（3）忠诚，可行性，可接受性，满意度和参与度，以及（4）最初实施忠诚度和随着时间的变化对学生出勤，知识，技能，意图和与青少年约会暴力有关的行为的变化的影响。