Prevention of Young Adult Drug Use in Club Settings

描述（由申请人提供）：这是一项研究的延续（竞争性延续），该研究的重点是预防以电子音乐舞蹈活动（EMDE）为特色的俱乐部环境中的药物使用和相关风险行为。我们的第一项研究提供的证据表明，参加这类活动的吸毒者人数足够多，足以保证下一步，即，以测试在俱乐部实施先前证明有效的环境预防策略的可行性。拟议的研究将实施和测试实施旨在减少俱乐部中药物使用和其他危险行为的环境预防战略的可行性（例如，吸毒和吸毒者在俱乐部的存在以及与毒品有关的和其他危险行为，如吸毒驾驶、过量、性冒险、攻击性行为）。我们的具体目标如下：具体目标1：在俱乐部实施环境变化战略之前，衡量环境指标、东道国政策、顾客特征和行为。具体目标二：在俱乐部实施环境干预措施，评估和跟踪实施这些战略的可行性和实施的可靠性。具体目标3：检查干预前后药物使用水平和药物相关风险的变化，解释环境预防策略采用的变化。这项可行性研究将包括总共四个俱乐部，以测试环境预防战略。两个俱乐部将被随机分配在第二年开始时接受干预，而另外两个俱乐部将被要求再等待一年。在我们的分析部分中讨论了这种改进的交叉设计。我们的数据收集时间表包括5次主要的数据收集，间隔约6个月，从干预前的基线测量开始。每个主要的数据波将包括多个数据源：俱乐部的观察，主持人/工作人员访谈（每波20次访谈）和门户网站从顾客（n=2000）收集的数据。广告评估也将每月收集。对俱乐部的额外观察将在主要数据波收集和广告评估之间进行，每月进行。计划从我们以前的研究中采取措施以及一些额外的问题（例如，就环境战略实施过程中遇到的障碍与主办方和工作人员进行访谈）。因此，本次竞争性更新的总体设计基于我们在先前研究中测试的措施（见附录），以及基于干预措施和我们从先前工作中学到的知识（见下文的测量部分）实施的新措施。拟议的申请不是一项功效研究，而是一项可行性研究，旨在测试俱乐部的环境战略是否可以实施，评估实施的障碍和障碍，并证明少数俱乐部的变化，可以保证在随后的申请中对众多地点进行全面的功效研究。公共卫生相关性：该研究将测试环境预防策略的可行性，以电子音乐舞蹈活动（EMDE）为特色的俱乐部，毒品使用率高的地点和其他危险行为。与俱乐部所有者，经理和工作人员合作，这种干预将测试降低风险的策略是否有效。这项研究的优势包括关注年轻的职业成年人以及大学生。此外，我们的初步工作表明，在这种情况下发现了个体的多样性。最后，研究小组与娱乐业建立了良好的合作关系，使这项工作特别及时。

DESCRIPTION (provided by applicant): This is a renewal (competing continuation) for a study that focuses on preventing drug use and related risky behavior in club settings that feature electronic music dance events (EMDEs). Our first study provided evidence that the number of drug users attending this type of event was sufficiently large to warrant the next step, i.e., to test the feasibility of implementing previously-proven environmental prevention strategies in clubs. The proposed study will implement and test the feasibility of implementing environmental prevention strategies designed to reduce drug use and other risky behaviors in clubs (e.g., presence of drug use and drug users in the clubs and drug-related and other risky behaviors such as drugged driving, overdoses, sexual risk-taking, aggressive behaviors). Our specific aims are as follows: Specific Aim 1: To measure environmental indicators, host policies, and patron characteristics and behaviors prior to implementing environmental change strategies in clubs. Specific Aim 2: To implement environmental interventions in the clubs and to assess and track the feasibility of implementing these strategies and fidelity of this implementation. Specific Aim 3: To examine the changes from pre- to post-intervention levels of drug use and drug related risks, accounting for the changes in the adoption of environmental prevention strategies. A total of four clubs will be included in this feasibility study to test the environmental prevention strategies. Two clubs will be randomly assigned to receive the intervention at the start of the second year, while the other two clubs will be required to wait an additional year for the intervention. This modified crossover design is discussed in our analyses section. Our data collection timeframe includes 5 major waves of data collection approximately six months apart and beginning with baseline measures prior to intervention. Each major data wave will include multiple sources of data: Observations of clubs, Host/staff interviews (20 interviews per wave) and Portal data collections from patrons (n=2000). Advertising assessments also will be collected monthly. Additional observations of clubs will occur halfway between the major data wave collection and advertising assessments will occur monthly. Measures from our prior studies as well as some additional questions are planned (e.g., host and staff interviews about barriers encountered in the implementation of environmental strategies). Hence, the overall design for this competitive renewal builds upon the measures we have tested in the prior studies (see appendices) as well as implementing new measures based upon the intervention and what we have learned from the prior work (see measurement section below). The proposed application is not an efficacy study, rather a feasibility study designed to test whether the environmental strategies for clubs can be implemented, to assess the barriers and impediments to the implementation and to demonstrate change within a small number of clubs that can warrant a full-scale efficacy study across numerous sites in a subsequent application. PUBLIC HEALTH RELEVANCE: The research will test the feasibility of environmental prevention strategies for clubs that feature electronic music dance events (EMDEs), locations having high rates of drug use and other risky behaviors. Working with club owners, managers, and staff, this intervention will test whether strategies to reduce risks. Strengths of the study include the focus on young working adults, as well as college students. Further, our initial work indicates that a diversity of individuals is found in this setting. Finally, the study team has developed excellent collaborative relationships with the entertainment industry making this effort especially timely.