Feasibility of an Internet-Based Model for Implementation of a Prevention Program

说明(申请人提供)：尽管在医疗保健方面投资巨大，但提供和利用有效服务的障碍往往导致获得预防性行为健康方案的机会有限，特别是对生活在农村地区的少数民族和穷人来说，结果是 在这些群体的健康差距方面，这是一个与NIDA使命相关的问题。拟议的试点研究的目的是测试创新的实施模式的可行性，该模式利用 在传播非洲裔美国人强大家庭方案(SAAF)方面提供现场在线培训和技术援助，这是一项普遍的预防干预措施，被证明在减少农村AA青少年使用酒精、烟草和大麻以及应对其他挑战方面是有效的。因此，SAAF有可能对生活在南部农村的数百万再障青年及其家人的生活产生重大的公共卫生影响。如果有效，拟议的基于网络的方法将促进向农村地区传播和实施SAAF，并可能促进其他基于经验的预防干预措施，因为在农村地区，很难提供网络方法所能提供的现场支持。SAAF的效力取决于其以社区为基础的执行系统的有效性，该系统取决于迄今面对面进行的非AA社区成员作为促进者的培训，这大大限制了更广泛的传播。因此，发展SAAF对公共卫生的影响的下一步是研究基于互联网的创新实施模式的可行性，在南部农村县使用两波岗前设计传播现场在线SAAF培训和TA。根据调查结果，将在RO1应用程序中对实施SAAF与家庭的两种交付模式(基于互联网的和标准的面对面)进行随机比较有效性试验。我们的具体目标是：1)测试在使用基于互联网的方法实施SAAF干预模式时培训忠诚的促进者的可行性；2)测试基于互联网的SAAF培训和技术援助将有助于促进促进者忠诚度的实施者过程的可行性；3)探索促进者的特征对团队实施环境和忠诚度促进实施者过程之间的关系的影响程度；以及4)收集实施SAAF-TDM所需的成本和资源信息的试点方法，以便在未来的应用中用于制定成本效益研究。 公共卫生相关性：提供预防性行为健康方案的障碍往往会导致少数群体和生活在农村地区的穷人的差异。这项试点研究测试了一种创新模式的可行性，该模式利用技术提供强大的非裔美国人家庭(SAAF)，这是一种普遍的预防干预措施，被证明在减少农村AA青少年酗酒、吸烟和大麻使用以及应对其他挑战方面有效。如果有效，SAAF有可能对生活在南部农村的数百万非裔美国青年及其家人的生活产生重大的公共卫生影响。

DESCRIPTION (provided by applicant): Despite huge investments in health care, barriers to the delivery and utilization of effective services often lead to limited access to preventive behavioral health programs, especially for minorities and the poor living in rural areas, resulting in health disparities for these groups, an issue relevant to NIDA's mission. The purpose of the proposed pilot study is to test the feasibility of an innovative implementation model that utilizes technology to deliver live, on-line training and TA in the dissemination of the Strong African American Families Program (SAAF), a universal preventive intervention shown to be effective in reducing rural AA youths' alcohol, tobacco and marijuana use, and addressing other challenges. Thus SAAF has the potential of making a significant public health impact on the lives of millions of AA youth and their families living in the rural south. If effective, the proposed web-based approach will facilitate dissemination and implementation of SAAF, and potentially other empirically-based preventive interventions, to rural areas where it is difficult to provide the on-site support that a web approach can deliver. The efficacy of SAAF is tied to the effectiveness of its community-based implementation system, which has hinged on the training of lay AA community members as facilitators that to date has been conducted face-to-face, which significantly limits more widespread dissemination. Therefore, the next step in developing SAAF's public health impact is to examine the feasibility of an innovative internet-based implementation model in disseminating live, on-line SAAF training and TA in a rural southern county using a two-wave pre-post design. Contingent on the findings, a randomized comparative effectiveness trial of two delivery models (internet-based; standard face-to-face) in the implementation of SAAF with families will be conducted in an RO1 application. Our specific aims are to: 1) test the feasibility of training facilitators with fidelity in the implementation o the SAAF intervention model using an internet-based approach; 2) test the feasibility that internet-based SAAF training and TA will contribute to fidelity-promoting implementer processes in the facilitators; 3) explore the extent to which facilitator characteristics impact the relationship between the team implementation climate and fidelity-promoting implementer processes; and 4) pilot methods for the collection of cost and resource information needed for implementation of SAAF-TDM to be used in future applications for the development of cost effectiveness studies. PUBLIC HEALTH RELEVANCE: Barriers to the delivery of preventive behavioral health programs often lead to disparities for minorities and the poor living in rural areas. This pilot study tests the feasibility of an innovative model that utilizes technology for the delivery of Strong African American Families (SAAF), a universal preventive intervention shown to be effective in reducing rural AA youths' alcohol, tobacco and marijuana use, and addressing other challenges. If effective, SAAF has the potential of making a significant public health impact on the lives of millions of African American youth and their families living in the rural south.