Enhancing the Impact of Evidence-Based Prevention for Youth: The Rapid Adaption to Prevent Drug Use (RAPD) Implementation Strategy

增强青少年循证预防的影响：快速适应预防吸毒 (RAPD) 实施策略

• 批准号: 10510068
• 负责人: Andria B Eisman
• 金额: $ 23.1万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10510068
• 关键词: Address; Adolescent; Adopted; Attention; COVID-19; Communities; Cost Analysis; Costs and Benefits; Data; Drug usage; Early Intervention; Educational Curriculum; Effectiveness; Event; Evidence based intervention; Family; Foundations; Future; Goals; Health; Health behavior; Health education; Health system; Health trends; Hybrids; Infrastructure; Intervention; Low income; Methods; Michigan; Modeling; Morbidity - disease rate; Pharmaceutical Preparations; Phase; Population; Poverty; Prevention; Process; Public Health; Recording of previous events; Reporting; Research; Research Proposals; Resources; Risk; Schools; Shapes; Societies; Students; Substance Use Disorder; Support System; System; Testing; Time; Training; Trauma; Update; Youth; base; comparative; coronavirus disease; cost; cost effectiveness; cost outcomes; design; drug abuse prevention; drug misuse; drug standard; economic evaluation; evidence base; implementation evaluation; implementation outcomes; implementation science; implementation strategy; improved; innovation; mortality; multiple drug use; novel; novel therapeutics; pilot test; programs; rapid test; rapid testing; response; risk perception; skills; social exclusion; stakeholder perspectives; stem; teacher; trend; vaping

Drug use trends change rapidly among youth, leaving intervention experts struggling to respond to emerging drugs promptly. We have a critical need to advance implementation strategies to optimize system responsiveness to these emerging issues. COVID-19 has increased the urgency for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts. Tier 1 evidence-based interventions (EBIs), such as the Michigan Model for HealthTM (MMH) lend themselves to addressing emerging trends. Our overall objectives are to 1) Improve the responsiveness of school-based EBIs in addressing urgent issues and 2) Find ways to support teachers in implementing updated EBIs, attending to unique considerations of low-resource schools. We will use After Action Review (AAR), to guide the systematic design of RAPD, Rapid Adaptation to Prevent Drug use, a novel bundle of implementation strategies. AAR is a reflective process focused on improving public health systems’ rapid response capacity. Key phases of AAR include: 1) Objective observation; 2) Analyze gaps/best practices, 3) Identify and test suitable implementation strategies to improve responsiveness to the next event (e.g., COVID-related drug use escalation). Sustainable strategies are central to achieving our objectives. Thus, we will also conduct a preliminary stakeholder-focused cost analysis. The rationale for this research is that designing and testing RAPD will enhance schools’ capacity to respond to urgent drug issues sustainably, and provide up-to-date, relevant resources for effective and equitable prevention. The proposed research will address the following aims: Aim 1: Identify implementation gaps and best practices in responding to urgent drug use events. We will use AAR to review the statewide response to the vaping crisis using the MMH using rapid qualitative analysis and identify gaps to be addressed with RAPD. Aim 2: Design and pilot test RAPD implementation and effectiveness. We will design a RAPD to optimize responses to urgent drug use events and pilot test in schools serving low-income students to assess equity. We will assess implementation outcomes using a convergent mixed methods design, and effectiveness via a group RCT comparing RAPD and standard MMH implementation. Aim 3: Assess costs and benefits of RAPD from multiple stakeholder perspectives. We will use an exploratory sequential mixed methods design to understand and identify key costs and outcomes from key stakeholder perspectives. We will develop a costing guide and conduct a preliminary cost analysis to inform an economic evaluation for a larger trial. The proposed research is innovative because to date implementation strategies have not been designed to support systems in responding to changing public health trends with attention to equity. In addition, this study focuses on implementation strategies to reduce the health impact of emerging drugs and provide an infrastructure to make future adaptations that can be applied in other contexts. The proposed research is significant because it will advance applying implementation science to achieve access, cost and equity for drug use prevention.

在青年中，药物使用趋势迅速变化，使干预专家努力应对新兴 毒品迅速。我们迫切需要提高实施策略以优化系统 对这些新兴问题的响应。 Covid-19使实施科学的紧迫性提高到 使用现有的治疗和预防工作促进快速，公平的回应。第1层基于证据 干预措施（EBIS），例如密歇根州HealthTM（MMH）的模型，可以解决新兴 趋势。我们的总体目标是1）提高基于学校的EBI的响应能力，以解决紧急 问题和2）寻找支持教师实施更新的EBI的方法，并参与了独特的注意事项 低资源学校。我们将使用After Action Review（AAR）来指导RAPD的系统设计， 快速适应以防止吸毒，这是一种新颖的实施策略。 AAR是一种反思 过程的重点是改善公共卫生系统的快速响应能力。 AAR的关键阶段包括：1） 客观观察； 2）分析差距/最佳实践，3）确定并测试适当的实施策略 提高对下一个事件的响应能力（例如，与共同相关的药物使用升级）。可持续战略 是实现我们的目标的核心。这，我们还将进行初步以利益相关者为中心的成本 分析。这项研究的理由是设计和测试RAPD将增强学校的能力 可持续地应对紧急药物问题，并提供最新的相关资源，以实施有效和 公平预防。拟议的研究将解决以下目的：目标1：确定实施 响应紧急吸毒事件的差距和最佳实践。我们将使用AAR来审查全州 使用MMH使用快速定性分析对烟雾危机的反应，并确定要解决的差距 与Rapd。目标2：设计和试点测试RAPD实施和有效性。我们将设计一个Rapd 在为低收入学生评估的学校中优化对紧急吸毒事件的反应和试点测试 公平。我们将使用收敛的混合方法设计和有效性评估实施结果 通过比较RAPD和标准MMH实现的组RCT。目标3：评估成本和收益 从多个利益相关者的角度来看。我们将使用探索性的顺序混合方法设计 从关键的利益相关者角度了解并确定关键成本和成果。我们将发展成本 指导和进行初步成本分析，以告知经济评估以进行更大的试验。提议 研究具有创新性，因为迄今为止实施策略尚未旨在支持系统 在响应不断变化的公共卫生趋势时，请注意公平。此外，这项研究重点是 实施策略，以减少新兴药物的健康影响，并提供基础设施以使 可以在其他情况下应用的未来改编。拟议的研究很重要，因为它将 提前应用实施科学来实现预防吸毒的访问，成本和股权。