Developing and Piloting a School Staff-Based Intervention to Reduce Alcohol and Drug Use Among Sexual Minority Youth

项目摘要/摘要 酒精和毒品的使用(例如，烟草和大麻的使用)是影响 年轻的比例。酒精和毒品的使用也给某些青年人口带来了不成比例的负担，例如 性少数群体青少年(SMY；即认为自己是男/女同性恋或双性恋的青少年，或有同样的- 性行为或吸引力)。与异性恋青年相比，SMY的比例高出600% 终生吸毒和酗酒的几率。尽管存在这些巨大的差异，但很少有循证干预措施 在SMY中存在减少酒精和药物使用的方法。然而，报告说有支持的成年人的SMY 在学校，学校联系越紧密，欺凌受害者越少，毒品和酒精的使用就越少。 因此，对学校教职员工(例如，教师、校长、护士、辅导员)进行培训的干预措施 理解SMY，支持SMY，并参与积极的旁观者行为，保护SMY免受欺凌 受害可能会减少吸毒和饮酒方面的性取向差异。此外，许多学校工作人员 他们希望支持SMY，但他们报告说，缺乏培训是他们的主要障碍。为了解决这些差距，我 将执行两个具体目标。在目标1中，我将开发一个在线电子学习干预，旨在提高 学校员工支持SMY的知识、技能和自我效能感。使用干预映射 方法，我将通过以下方式开发、用户测试和改进干预材料：与学校一起开展焦点小组 工作人员咨询委员会；通过与学校员工进行有声思考访谈来执行可用性测试；以及合作 拥有专业的电子学习开发人员。在目标2中，我将试行测试这一方法的可行性和初步效果 学校教职员工干预，采用双臂整群随机对照试验。我要上高中了 参与MetroWest青少年健康调查(MWAHS)的全额资助调查基础设施， 位于马萨诸塞州波士顿郊外，那里在吸毒和饮酒方面仍然存在性取向差异。 MWAHS每两年对每所学校的所有学生进行调查，提供充足的学生水平数据。 同时，我将从所有学校教职员工那里收集新的纵向调查数据(基线和6个月的跟踪调查) 在每一所注册的学校内。这种电子学习干预很容易修改，在经济上可扩展，使 它易于广泛传播，有可能在减少毒品和酒精使用方面产生人口层面的影响 差距。为了顺利完成我的研究，我将接受以下方面的培训：(1)利益相关者的发展- 知情干预，特别是电子学习方案；(2)实施科学研究；和(3) 实验研究的设计与分析。在一个强大的跨学科指导团队的指导下，我计划 培训活动包括辅导会议、正式课程、培训机构、科学研讨会和 研究会议。在成功完成我的研究和培训计划后，我将被推动 为了实现我的长期目标，成为一名独立的科学研究人员，专门从事 利益相关者知情干预科学，旨在减少SMY的药物和酒精使用差异。

PROJECT SUMMARY/ABSTRACT Alcohol and drug use (e.g., tobacco and marijuana use) are major public health problems affecting large proportions of youth. Alcohol and drug use also disproportionately burden certain youth populations, such as sexual minority youth (SMY; i.e., adolescents who identify as gay/lesbian or bisexual, or who have same- gender sexual behaviors or attractions). Compared with heterosexual youth, SMY have up to 600% higher odds of lifetime drug and alcohol use. Despite these substantial disparities, few evidence-based interventions exist for reducing alcohol and drug use among SMY. Nevertheless, SMY who report having supportive adults at school, greater school connectedness, and lower bullying victimization have lower drug and alcohol use. Therefore, an intervention that trains school staff (e.g., teachers, principals, nurses, counselors) to better understand SMY, support SMY, and engage in positive bystander behaviors that protect SMY from bullying victimization may reduce sexual-orientation disparities in drug and alcohol use. Furthermore, many school staff desire to support SMY, but they report a lack of training as their primary impediment. To address these gaps, I will execute two Specific Aims. In Aim #1, I will develop an online e-learning intervention aimed at improving school staff’s knowledge, skills, and self-efficacy for supporting SMY. Using the intervention mapping approach, I will develop, user-test, and refine intervention materials by: conducting focus groups with a School Staff Advisory Board; performing usability tests via think aloud interviews with school staff; and collaborating with professional e-learning developers. In Aim #2, I will pilot test the feasibility and preliminary efficacy of this school staff-based intervention using a two-armed cluster-randomized controlled trial. I will enroll high schools participating in the fully-funded survey infrastructure of the MetroWest Adolescent Health Survey (MWAHS), located outside Boston, Massachusetts, where sexual-orientation disparities in drug and alcohol use still exist. Biennially, the MWAHS administers surveys to all students in each school, providing ample student-level data. In tandem, I will collect new longitudinal survey data (baseline and 6-month follow-up) from all school staff within each enrolled school. This e-learning intervention is easily modifiable and economically scalable, making it apt for wide dissemination with the potential for population-level impact in reducing drug and alcohol use disparities. To successfully complete my research, I will acquire training in: (1) the development of stakeholder- informed interventions, particularly e-learning programs; (2) implementation science research; and (3) the design and analysis of experimental studies. Guided by a strong interdisciplinary mentorship team, my planned training activities include mentorship meetings, formal coursework, training institutes, scientific seminars, and research conferences. Upon successful completion of my research and training plans, I will be propelled towards achieving my long-term goal, which is to become an independent scientific researcher specializing in stakeholder-informed intervention science aimed at reducing drug and alcohol use disparities for SMY.