Preparing to Run Effective Prevention (PREP)

描述（由申请人提供）：作为一个国家，美国大量投资于社区组织进行干预，通过研究证明，以减少青少年的酒精和毒品使用率高。在帮助社区高质量地实施这些方案方面的投资要少得多。虽然存在许多基于证据的方案来解决酒精和药物使用问题，但社区在实施这些方案并取得与研究人员相同的结果方面面临困难。这一"差距"是因为资源有限，预防工作复杂，社区往往缺乏能力或知识、态度和技能来很好地实施"现成"项目。弥补这一差距的常用方法，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，建设社区的能力是一种可以提高执行质量和成果的方法。取得成果（GTO）是一种实施支持干预措施，可提高从业人员开展循证方案的能力，但其对忠诚度和青年成果的影响尚未得到研究。该研究-准备运行有效预防（PREP）-将是一项群集随机对照试验，使用来自33个合作男孩和女孩俱乐部网站（网站）的中学生（990）和项目工作人员的主要数据，以评估GTO如何影响保真度，结果和循证计划的成本，以防止酒精和药物使用（项目选择，PC）。所有33个研究中心都将接受PC培训。16个研究中心将以典型的 基于社区的组织（仅PC）; 17个站点将开展由GTO增强的PC，包括培训、现场技术援助和GTO书面手册。该研究将：（1）评估GTO的使用，并比较PC + GTO和仅PC之间的站点容量;（2）比较PC + GTO和仅PC组之间的PC保真度;（3）比较PC + GTO（n = 510）和仅PC（n = 480）组中中学生的酒精和大麻结果;以及（4）评估GTO影响的成本效益。为了实现这些目标，我们将收集有关GTO交付和使用的数据（例如，交付的方法，持续时间，主题）;工作人员实施基于研究的干预措施的能力;对计划交付的观察（忠诚度监测）;青年参与者的使用和态度，酒精和大麻，通过 在基线和3个月和6个月随访时进行调查;以及单独PC和PC + GTO的成本。分析将检查干预（PC + GTO）和对照（仅PC）研究中心的容量、PC保真度、结果和成本随时间的变化之间的差异，并考虑研究中心内的聚类。PREP研究可以扩展实施研究，并作为政府和其他机构如何支持在广泛领域中强有力地实施循证计划的模型。这些成果对于为青年提供机会，使他们成为健康和有生产力的成年人十分重要。

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 alcohol and drug use among teens. Much less is invested in helping communities implement these programs with quality. Although many evidence-based programs exist to address alcohol and drug use, 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. Getting To Outcomes (GTO) is an implementation support intervention shown to improve the capacity of practitioners to conduct evidence-based programs, but its impact on fidelity and youth outcomes has not been studied. The study-Preparing to Run Effective Prevention (PREP)-will be a cluster randomized controlled trial using primary data from middle school youth (990) and program staff from 33 cooperating Boys and Girls Clubs sites (Sites) to assess how GTO impacts the fidelity, outcomes, and costs of an evidence-based program to prevent alcohol and drug use (Project CHOICE, PC). All 33 sites will receive training in PC. 16 Sites will conduct PC in a way typical of community-based organizations (PC only); 17 Sites will conduct PC augmented by GTO, comprised of training, onsite technical assistance, and a written GTO manual. The study will: (1) Assess the use of GTO and compare Sites' capacity between PC+GTO and PC only; (2) Compare PC fidelity between PC+GTO and PC only groups; (3) Compare alcohol and marijuana outcomes of middle-school youth in the PC+GTO (n=510) and PC only (n=480) groups; and (4) Assess the cost-effectiveness of GTO's impact. 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); youth participants' use of, and attitudes towards, alcohol and marijuana via a survey at baseline and 3 and 6 months follow-up; and costs of both PC alone and PC+GTO. Analyses will examine differences between intervention (PC+GTO) and control (PC only) Sites' capacity, PC fidelity, outcomes, and costs over time, accounting for clustering within site. The PREP study could expand implementation research and serve as a model for how the government and other agencies support strong implementation of evidence- based programs in a wide array of domains. These outcomes are important to providing opportunities for youth to become healthy and productive adults.