Preparing to Run Effective Prevention (PREP)

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，以进行经研究证明的干预措施，以降低青少年中酗酒和吸毒的高比例。在帮助社区高质量地实施这些项目上的投资要少得多。尽管存在许多以证据为基础的项目来解决酒精和药物使用问题，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。取得成果（GTO）是一项实施支持干预措施，旨在提高从业人员开展循证项目的能力，但其对保真度和青年成果的影响尚未得到研究。这项研究——准备开展有效预防（PREP）——将是一项集群随机对照试验，使用来自中学生（990人）和33个合作的男孩和女孩俱乐部（sites）的项目工作人员的主要数据，以评估GTO如何影响以证据为基础的预防酒精和药物使用项目的保真度、结果和成本（Project CHOICE， PC）。所有33个站点都将接受PC培训。站点将以典型的方式进行PC

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.