Getting to Outcomes and Underage Drinking

描述(申请人提供)：未成年人饮酒对社区公共健康造成负面影响，导致交通事故、危险的性行为和酒精障碍。研究人员表明，有几种基于政策的策略可以用来限制未成年人饮酒，以此作为防止未成年人饮酒的一种方式。然而，社区在实现这些策略的研究人员所展示的成果方面面临困难。这种“差距”是因为资源有限，这些战略很复杂，社区往往缺乏将“现成”战略转化为实践的能力。共同的翻译努力，如信息传播，未能改变地方一级的做法或成果，部分原因是它们没有充分建设能力或使用社区投入。该项目将评估一种模式--取得成果(GTO)--旨在通过建设社区的预防能力，帮助社区成功地将循证战略转化为实践。对使用GTO与个别专注的、基于教育的药物滥用预防计划的联盟的研究表明，GTO可以帮助社区提高实施循证战略和获得健康结果的能力。这项提案是对基于GTO模型的一项新干预措施的评估--得出未成年人饮酒的结果(GTO-UD)。GTO-UD由书面逐步指南、面对面培训和现场技术援助组成，专门为帮助翻译针对公共政策层面的循证未成年人饮酒战略而量身定做。该项目将是一项包含有效性研究要素的随机对照疗效试验(即，在社区环境中实施)，将3个使用GTO-UD的未成年人饮酒预防联盟与3个类似的未使用GTO-UD的联盟进行比较。这种强调概括性和外部有效性的混合设计现在被推荐用于基于社区的研究。该项目将在目标1)提供GTO-UD干预措施并评估其实施情况(联盟成员的标准化调查和重点小组)；在目标2)评估GTO-UD在多大程度上改进了环境战略的翻译(重点小组、保真度核对清单、实施评级)；目标3)评估GTO-UD在多大程度上改进了预防能力和绩效(标准化调查和对联盟成员的访谈)；在目标4)评估使用GTO-UD协助研究翻译是否减少了未成年饮酒和与酒精有关的撞车事故和死亡(12年级学校调查、档案撞车数据)。联盟代表将积极参与研究的所有阶段。这一结果将对社区如何实施以政策为导向的未成年人饮酒预防战略，以减少因酒精相关的撞车事故和其他负面健康后果造成的死亡产生影响，这是疾控中心国家伤害预防和控制中心的一个关键优先事项。

DESCRIPTION (provided by applicant): Underage drinking negatively impacts public health in communities, causing traffic accidents, risky sexual behaviors and alcohol disorders. Researchers have shown that there are several policy-based strategies that can be used to restrict minors' access to alcohol as a way to prevent underage drinking. However, communities face difficulty in achieving outcomes demonstrated by the researchers of these strategies. This "gap" is because resources are limited, these strategies are complex, and communities often lack the capacity to translate "off the shelf" strategies into practice. Common translation efforts, such as information dissemination, fail to change practice or outcomes at the local level in part because they do not sufficiently build capacity or use communty input. This project will assess a model-Getting To Outcomes (GTO)- designed to help communities successfully translate evidence-based strategies into practice by building their prevention capacity. Studies of coalitions who used GTO with individually focused, education-based substance abuse prevention programs have shown it can help communities improve their capacity to implement evidence based strategies and get health outcomes. This proposal is an evaluation of a new intervention based on the GTO model-Getting To Outcomes for Underage Drinking (GTO-UD). Composed of a written step by step guide, face-to-face training, and onsite technical assistance, GTO-UD has been specifically tailored to help translate the evidence-based underage drinking strategies aimed at the public policy level. The project will be a randomized controlled efficacy trial with elements of an effectiveness study (i.e., implementation in community- based setting), comparing 3 underage drinking prevention coalitions using GTO-UD with 3 similar coalitions who are not. Such blended designs that emphasize generalizability and external validity are now recommended for community-based research. The project will, in Aim 1) deliver the GTO-UD intervention and evaluate its implementation (standardized surveys and focus groups of coalition members); in Aim 2) assess how much GTO-UD improved the translation of the environmental strategies (focus groups, fidelity checklists, implementation ratings); Aim 3) assess how much GTO-UD improved prevention capacity and performance (standardized surveys and interviews of coalition members); in and in Aim 4) assess whether using GTO-UD to aid research translation reduces underage drinking and alcohol-related crashes and fatalities (12th grade school survey, archival crash data). Coalition representatives will be actively involved in all phases of the research. Results will have implications for how communities can implement policy-oriented underage drinking prevention strategies to reduce deaths due to alcohol-related crashes and other negative health outcomes, a key priority for the CDC's National Center for Injury Prevention and Control.