Enhancing Quality Interventions Promoting Healthy Sexuality

描述（由申请人提供）：作为一个国家，美国在以社区为基础的组织中投入了大量资金，以进行经研究证实的干预措施，以降低青少年意外怀孕、性传播感染和艾滋病毒的高发率。在帮助社区高质量地实施这些项目上的投资要少得多。尽管存在许多以研究为基础的项目来解决青少年怀孕和性传播感染问题，但社区在实施这些项目并取得与研究人员相同的成果方面面临困难。造成这种“差距”的原因是资源有限，预防复杂，社区往往缺乏实施“现成”项目所需的能力或知识、态度和技能。弥补这一差距的常见方法，如信息传播，未能改变地方一级的做法或结果，部分原因是它没有充分解决社区从业人员的能力问题。因此，建设社区能力是一种可以提高实施质量和成果的方法。拟议的研究将采用随机对照设计和来自中学青少年（960名）和来自32个合作男孩和女孩俱乐部（俱乐部）的项目工作人员的主要数据，以评估一项名为“取得成果”（GTO）的能力建设干预措施如何提高基于研究的干预措施的实施质量，以改善青少年性健康（Making Proud Choices， MPC）。具体而言，本研究将：(1)评估GTO的利用及其对方案工作人员执行MPC能力的后续影响；(2)评估使用GTO的俱乐部在MPC保真度方面比不使用GTO的俱乐部有更大改善的程度；(3)评估使用GTO的俱乐部在青少年性健康结果方面比比较俱乐部有更大改善的程度。为了实现这些目标，我们将收集有关GTO提供和利用的数据（例如，提供方法、持续时间、主题）；工作人员实施基于研究的干预措施的能力；项目执行情况观察（保真度监测）；青少年参与者的性行为、怀孕、性传播感染、避孕套使用以及对性的知识/态度。随着时间的推移，分析将检查干预和控制站点之间的差异，说明站点内青年聚集的原因。这些成果对儿童发展中心的重点是为青年提供成为健康和有生产力的成年人的机会非常重要。

DESCRIPTION (provided by applicant): As a nation, the U.S. invests heavily in community-based organizations to conduct interventions, proven through research, to reduce the high rates of unplanned pregnancies and sexually transmitted infections (STIs) and HIV among teens. Much less is invested in helping communities implement these programs with quality. Although many research-based programs exist to address teen pregnancy and STIs, communities face difficulty implementing them and achieving the same outcomes as researchers. This "gap" is because resources are limited, prevention is complex, and communities often lack the capacity-or the knowledge, attitudes, and skills-needed to implement "off the shelf" programs well. Common ways to bridge this gap, such as information dissemination, fail to change practice or outcomes at the local level in part because it does not sufficiently address capacity of community practitioners. Therefore, building a community's capacity is a method that could improve the quality of implementation and outcomes. The proposed study will use a randomized controlled design and primary data from middle school youth (960) and program staff from 32 cooperating Boys and Girls Clubs (Clubs) to assess how a capacity building intervention called Getting To Outcomes (GTO) augments the quality of implementation of a research-based intervention to improve teen sexual health (Making Proud Choices, MPC). Specifically, the study will: (1) Assess the utilization of and subsequent effects of GTO on program staff capacity to implement MPC; (2) Assess the degree to which Clubs using GTO show greater improvements in MPC fidelity than Clubs that are not using GTO; and (3) Assess the degree to which Clubs using GTO show greater improvements on teen sexual health outcomes than the comparison Clubs. To address these aims we will collect data on the delivery and utilization of GTO (e.g., method of delivery, duration, topics); staff capacity to implement research-based interventions; observations of program delivery (fidelity monitoring); and youth participants' sexual activity, pregnancy, STIs, condom use, and knowledge/ attitudes towards sex. Analyses will examine differences between intervention and control sites over time, accounting for clustering of youth within site. These outcomes are important to NICHD's focus on providing opportunities for youth to become healthy and productive adults.