Addressing High School Marijuana Use in Context of Increasing Social Acceptance

说明(申请人提供)：青少年吸食大麻与各种不良的健康和心理社会后果有关。然而，围绕大麻使用的规范背景迅速变化，对预防提出了重大挑战。到目前为止，已有20个州和哥伦比亚特区将医用大麻合法化，17个州已将持有大麻合法化，两个州已将娱乐用途大麻合法化。鉴于大麻使用正常化的势头，需要采取新的办法对青年进行干预，以减少大麻的使用和与大麻使用有关的风险。目的：这项可行性研究将开发一种干预措施，使用传统媒体和移动技术相结合的方式，通过增加对高风险使用的知识和关注，并提高对此类行为与个人自主权和中介机构不一致的认识，减少高中生使用大麻。具体目标是：(1)调整以前测试过的大麻交流方法，用于高中；(2)测试使用智能手机技术在接近做出行为决定的时候传递适当信息的可行性；(3)通过增加对高风险使用的知识和关注，以及这种行为与个人自主性的不一致，对这种运动的潜力进行有效性测试，以降低高中生使用大麻的流行率、使用大麻的数量和频率；(4)评估这些方法是否对酒精使用相关结果有积极影响。方法：我们将组织焦点小组来制定干预的信息和材料。在消息开发之后，我们将与Klein Buendel(KB)合作，开发智能手机应用程序和文本消息平台。Klein Buendel(KB)是一家专门从事公共卫生干预手机应用程序的多媒体开发公司。这项干预措施将在旧金山湾区总共六所学校实施，采用交叉设计。加州健康儿童调查是一项全州范围的调查，允许定制问题，将在研究的1-3年内在每所学校进行，并将用于评估干预的效果。在学校实施干预措施后，我们会与学校行政人员进行面对面的面谈，以了解他们对干预措施的反应和经验。创新：这项可行性研究将探索使用智能手机技术和短信作为一种方式，以扩大传统学校为基础的媒体方法的有效性，并在有关大麻使用的行为决定附近的时间和地点向青少年传播预防信息。这种以媒体为基础的方法不需要教室或教师的时间，使其在对学校学习成绩的要求日益增长、可用于预防的学校资源减少的时代具有广泛采用的可行性。如果成功，这项可行性研究将为更大范围的随机试验提供基础。

DESCRIPTION (provided by applicant): Marijuana use among adolescents is associated with a variety of negative health and psychosocial outcomes. The rapidly changing normative context surrounding marijuana use, however, raises significant challenges for prevention. To date, 20 states and the District of Columbia have legalized marijuana for medical use, 17 states have decriminalized marijuana possession, and two states have legalized marijuana for recreational use. Given the momentum towards normalization of marijuana use, new approaches are needed to intervene with youth to reduce marijuana use and risks associated with marijuana use. Aims: This feasibility study will develop an intervention, using a combination of traditional media and mobile technologies to reduce marijuana use among high school students by increasing knowledge and concern regarding high-risk use and raising awareness of the inconsistency of such behaviors with personal autonomy and agency. Specific aims are (1) adapting previously-tested marijuana communication approaches for use in high schools; (2) testing feasibility of use of smartphone technology to deliver appropriate messages proximate to time of behavioral decision; (3) conducting an efficacy test regarding potential of such a campaign to reduce the prevalence of use and quantity and frequency of marijuana use among high school students, via increasing knowledge and concern regarding high-risk use, and the inconsistency of such behaviors with personal autonomy; (4) assessing whether these approaches have a positive effect on alcohol-use related outcomes. Approach: We will conduct focus groups to develop the messages and materials for the intervention. Following message development, we will work collaboratively with Klein Buendel (KB), a multi-media development firm that specializes in mobile phone applications for public health interventions, to develop a smartphone app and text messaging platform. The intervention will be implemented in a total of six schools in the San Francisco Bay Area using a cross-over design. The California Healthy Kids Survey, a state-wide survey that allows custom questions, will occur in each school in Years 1 - 3 of the study, and will be used to assess the efficacy of the intervention. Following the implementation of the intervention in the schools, face-to- face interviews with school administrators will be conducted to ascertain their reactions to and experiences with the intervention. Innovation: This feasibility study will explore the use of smartphone technology and text messaging as a way to extend the effectiveness of traditional school-based media approaches and disseminate prevention messages to youths at a time and place proximal to behavioral decision regarding marijuana use. This media- based approach does not require classroom or teacher time, making it viable for widespread adoption in an era of growing demands for school academic performance and decreased available school resources for prevention. If successful, this feasibility study will provide the basis for a larger randomized tral.