Enhancing Quality Interventions Promoting Healthy Sexuality

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，以减少青少年中计划外怀孕和性传播感染（STI）和艾滋病毒的高发病率。在帮助社区高质量地实施这些方案方面的投资要少得多。虽然有许多以研究为基础的方案来解决少女怀孕和性传播感染问题，但社区在实施这些方案和取得与研究人员相同的成果方面面临困难。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。这项拟议的研究将使用随机对照设计和来自32个合作男孩和女孩俱乐部（俱乐部）的中学生（960）和项目工作人员的主要数据，以评估一种名为“获得结果”（GTO）的能力建设干预措施如何提高以研究为基础的干预措施的实施质量，以改善青少年性健康（做出自豪的选择，MPC）。具体而言，该研究将：（1）评估GTO的使用及其对计划人员实施MPC能力的后续影响;（2）评估使用GTO的扶轮社在MPC忠实度方面比未使用GTO的扶轮社表现出更大改善的程度;以及（3）评估使用GTO的扶轮社在青少年性健康结果方面比对照扶轮社表现出更大改善的程度。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，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;对方案提供情况的观察（忠诚度监测）;以及青年参与者的性活动、怀孕、性传播感染、避孕套使用情况和对性的知识/态度。分析将检查干预和控制网站之间的差异，随着时间的推移，占集群内的青年网站。这些成果对于NICHD重点关注为青年提供机会，使他们成为健康和有生产力的成年人具有重要意义。

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.