In-school and community media prevention

描述(由申请人提供)：本提案是一个竞争性的延续，旨在扩展我们的初步调查结果，以便为未来的传播努力提供坚实的基础。在之前的项目中，社区和学校媒体的联合预防努力显著减少了中学生中酒精和大麻的使用(在RGT中，在8个治疗社区和8个对照社区进行了评估)。在转向大规模传播之前，需要回答几个问题。首先，我们能否复制我们的发现，以及干预的成本效益是什么，作为干预的潜在使用者做出知情决定的基础？其次，仅仅是基于学校的媒体干预是否足以显示物质摄取或关键媒介的显著减少，以及相关的成本效益是什么？由于学校媒体的低成本和简单实施，广泛传播的潜力是非常有希望的。第三，基于社区的媒体努力的增量贡献是什么，以及与这一努力相关的成本效益？此外，根据先前研究的经验，我们可以更精确地检查导致这些基于媒体的干预措施的行为影响的中介因素。这项研究将使用24个社区的随机分组试验，以提供更高的敏感性来检查这些研究问题。每个社区将有两所学校参与，其中一所学校将被随机分配到学校媒体处理组，另一所学校将作为对照。一半的社区将被随机分配到社区媒体治疗。因此，学校和社区的治疗是交叉的，可以在HLM框架内对每个治疗进行评估。还将收集和评估成本效益数据。

DESCRIPTION (provided by applicant): This proposal is a competing continuation intended to extend our initial findings in order to provide a firm basis for future dissemination efforts. In the prior project, a combined community- and school-based media prevention effort significantly reduced alcohol and marijuana use among middle-school youth (assessed in 8 treatment vs. 8 control communities in a RGT). Several questions need to be answered before moving to large-scale dissemination. First, can we replicate our findings, and what is the cost-effectiveness of the intervention, as a basis for informed decision by potential users of the interventions? Second, is the school-based media intervention sufficient alone to show significant reduction in substance uptake or key mediators, and what is the associated cost-effectiveness? The potential for widespread dissemination due to low costs and simplicity of implementation of in-school media is extremely promising. Third, what is the incremental contribution of the community-based media effort, and the cost-effectiveness associated with that effort? In addition, we can examine with greater precision, based on our experience with the prior study, the mediators that lead to the behavioral impacts of these media-based interventions. This study will use a randomized group trial employing 24 communities to provide increased sensitivity to examine these research questions. Two schools will participate in each community, one of which will be randomly assigned to the school media treatment and one of which will serve as control. Half of the communities will be randomly assigned to the community media treatment. As a result, the school and community treatments are crossed and can each be assessed within an HLM framework. Cost-effectiveness data will also be collected and assessed.