Developing and Piloting a School Staff-Based Intervention to Reduce Alcohol and Drug Use Among Sexual Minority Youth

项目总结/摘要 酒精和药物使用（例如，烟草和大麻的使用）是影响大部分人的主要公共卫生问题。 青春的比例酒精和毒品的使用也给某些青年人带来了不成比例的负担， 性少数青年（SMY;即，青少年谁确定为同性恋/女同性恋或双性恋，或谁有相同的- 性行为或吸引力）。与异性恋青年相比，SMY高达600%。 终生吸毒和酗酒的几率尽管存在这些巨大的差异， 减少SMY中的酒精和药物使用。尽管如此，报告有支持性成年人的SMY 在学校，更大的学校联系和更少的欺凌受害者减少了毒品和酒精的使用。 因此，培训学校工作人员的干预措施（例如，教师，校长，护士，辅导员），以更好地 了解SMY、支持SMY并采取积极的旁观者行为来保护SMY免受欺凌 受害可能会减少吸毒和酗酒方面的性取向差异。此外，许多学校工作人员 他们希望支持SMY，但他们报告说，缺乏培训是他们的主要障碍。为了弥补这些差距，我 将有两个具体目标。在目标1中，我将开发一个在线电子学习干预，旨在提高 学校教职员支援中小学生的知识、技能及自我效能。使用干预映射 方法，我将开发，用户测试，并通过以下方式改进干预材料：与学校进行焦点小组讨论 工作人员咨询委员会;通过与学校工作人员的有声思维访谈进行可用性测试;并与 专业的电子学习开发人员。在目标#2中，我将试点测试这种方法的可行性和初步疗效。 学校工作人员为基础的干预使用双臂随机对照试验。我会报名参加高中 参与由全额资助的西部大都市青少年健康调查（MWAHS）， 位于马萨诸塞州波士顿郊外，那里仍然存在毒品和酒精使用的性取向差异。 MWAHS每两年对每所学校的所有学生进行一次调查，提供大量的学生层面的数据。 与此同时，我将从所有学校员工那里收集新的纵向调查数据（基线和6个月随访） 在每一所入学的学校里。这种电子学习干预很容易修改，经济上可扩展， 它易于广泛传播，有可能对减少吸毒和酗酒产生人口影响 差距。为了顺利完成我的研究，我将接受以下培训：（1）利益相关者的发展- 知情的干预措施，特别是电子学习计划;（2）实施科学研究;（3） 实验研究的设计和分析。在强大的跨学科导师团队的指导下，我计划 培训活动包括指导会议、正式课程、培训机构、科学研讨会， 研究会议。一旦我的研究和培训计划顺利完成，我将被推动 我的长期目标是成为一名独立的科学研究人员， 知情的干预科学，旨在减少SMY的药物和酒精使用差异。

PROJECT SUMMARY/ABSTRACT Alcohol and drug use (e.g., tobacco and marijuana use) are major public health problems affecting large proportions of youth. Alcohol and drug use also disproportionately burden certain youth populations, such as sexual minority youth (SMY; i.e., adolescents who identify as gay/lesbian or bisexual, or who have same- gender sexual behaviors or attractions). Compared with heterosexual youth, SMY have up to 600% higher odds of lifetime drug and alcohol use. Despite these substantial disparities, few evidence-based interventions exist for reducing alcohol and drug use among SMY. Nevertheless, SMY who report having supportive adults at school, greater school connectedness, and lower bullying victimization have lower drug and alcohol use. Therefore, an intervention that trains school staff (e.g., teachers, principals, nurses, counselors) to better understand SMY, support SMY, and engage in positive bystander behaviors that protect SMY from bullying victimization may reduce sexual-orientation disparities in drug and alcohol use. Furthermore, many school staff desire to support SMY, but they report a lack of training as their primary impediment. To address these gaps, I will execute two Specific Aims. In Aim #1, I will develop an online e-learning intervention aimed at improving school staff’s knowledge, skills, and self-efficacy for supporting SMY. Using the intervention mapping approach, I will develop, user-test, and refine intervention materials by: conducting focus groups with a School Staff Advisory Board; performing usability tests via think aloud interviews with school staff; and collaborating with professional e-learning developers. In Aim #2, I will pilot test the feasibility and preliminary efficacy of this school staff-based intervention using a two-armed cluster-randomized controlled trial. I will enroll high schools participating in the fully-funded survey infrastructure of the MetroWest Adolescent Health Survey (MWAHS), located outside Boston, Massachusetts, where sexual-orientation disparities in drug and alcohol use still exist. Biennially, the MWAHS administers surveys to all students in each school, providing ample student-level data. In tandem, I will collect new longitudinal survey data (baseline and 6-month follow-up) from all school staff within each enrolled school. This e-learning intervention is easily modifiable and economically scalable, making it apt for wide dissemination with the potential for population-level impact in reducing drug and alcohol use disparities. To successfully complete my research, I will acquire training in: (1) the development of stakeholder- informed interventions, particularly e-learning programs; (2) implementation science research; and (3) the design and analysis of experimental studies. Guided by a strong interdisciplinary mentorship team, my planned training activities include mentorship meetings, formal coursework, training institutes, scientific seminars, and research conferences. Upon successful completion of my research and training plans, I will be propelled towards achieving my long-term goal, which is to become an independent scientific researcher specializing in stakeholder-informed intervention science aimed at reducing drug and alcohol use disparities for SMY.