A Community Trial in Alaska to Prevent Youth's Use of Legal Products to Get High

阿拉斯加一项防止青少年使用合法产品吸毒的社区试验

• 批准号: 7796867
• 负责人: Joel William Grube
• 金额: $ 78.45万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7796867
• 关键词: Address; Adherence; Adolescent; Adopted; Aerosols; Alaska; Alaska Native; Arctic Regions; Attention; Authorization documentation; Behavior; Breathing; Caucasians; Caucasoid Race; Collaborations; Communities; Community Integration; Community Participation; Community Trial; Complex; Coughing; Development; Distal; Drops; Drug Prescriptions; Drug usage; Education; Educational Curriculum; Effectiveness; Ethnic group; Family; Feasibility Studies; Gasoline; Grant; Health; Home environment; Household Products; Inhalant dose form; Intervention; Legal; Letters; Manuscripts; Mediator of activation protein; Medicine; Methods; Minnesota; Modeling; Mouthwash; Non-Prescription Drugs; Outcome; Parents; Pharmaceutical Preparations; Policies; Population; Population Sizes; Prevalence; Prevention; Prevention approach; Problem behavior; Protocols documentation; Publications; Randomized; Randomized Controlled Trials; Readiness; Regulation; Research; Research Design; Research Infrastructure; Rural; Schools; System; Target Populations; Testing; Texas; United States; United States National Institutes of Health; Youth; adolescent substance abuse; base; design; dosage; effective intervention; efficacy testing; efficacy trial; evidence base; experience; frontier; innovation; instrument; interest; prevent; public health relevance; substance abuse prevention; tribal leader

DESCRIPTION (provided by applicant): This is a resubmission of a competing renewal of the grant entitled "A Community Trial to Prevent Inhalant Use in Alaska" (1 R01 DA015966). The original grant was designed as a feasibility study per NIH reviewers' request to develop and pilot-test an integrated Community Prevention Model (CPM) for Alaskan youth in the 5th - 7th grades to prevent the use of inhalants and ingestible harmful legal products (HLPs) to get high. This model consisted of community mobilization and environmental strategies that targeted retail outlets, homes, and schools, and a school-based prevention curriculum. As a result of the three-year feasibility study, intervention materials and research instruments have been developed and field tested in four Alaskan communities. Results from six publications and three manuscripts successfully implemented in the participating Alaskan communities, although there were concerns about it being too complex; and, there were sufficient changes in the key outcomes to warrant a full efficacy trial. In this application, we propose to test the efficacy of a condensed version of the CPM intervention consisting of community mobilization (CM) and environmental strategies (ES). The CM strategy is designed to enable community leaders and groups to take action. The ES in retail outlets, homes, and schools address community norms and values regarding youth use of HLPs, community adopted policies, restrictions and enforcement of these policies and restrictions, and retail, family, and school controls to reduce youth access to HLPs. The school based education curriculum has been dropped to reduce the complexity of a three-component CPM and to focus attention on the efficacy of environmental strategies in preventing HLPs use among youth. Commitments have been obtained from key community leaders in 16 remote rural (frontier) communities in Alaska that contain primarily a mixture of Caucasian or Alaska Native populations. The proximal outcomes are to and to reduce the availability of HLPs used in Alaskan frontier communities. The distal outcomes are to reduce the proportion of increase community readiness to implement environmental strategies to prevent HLP use, pre and early adolescents (5th, 6th, graders) who intend to or do experience inhaling or ingesting HLPs found in local retail outlets, homes, and schools. The research design is a five-year randomized control trial (RCT) in which eight pairs of matched frontier communities will be randomly assigned to experimental and control conditions. The 16 communities are located in various regions of the state, with population sizes that range from 536 to 5,937. This efficacy trial will integrate rigorous quantitative methods with participatory research principles consisting of community participation and collaboration that recognizes the unique cultural and 7th heritage of each study community. The significance of this study is its potential to produce an effective intervention to prevent youth's use of inhalants and other harmful legal products in remote rural and sustainable communities across the U.S. PUBLIC HEALTH RELEVANCE: The testing of the proposed Community Prevention Model under experimental conditions is particularly significant because there are few evidence-based prevention models for frontier communities like those in Alaska, western Texas, or northern Minnesota. Further, there are even fewer evidence-based prevention models that target use of inhalants and other harmful legal products. In addition, the integration of community mobilization and environmental strategies focusing on retail outlets, homes, and schools is innovative and invites the entire community to assume responsibility for youth substance abuse prevention rather than assuming it is the responsibility of only the school system.

描述（由申请人提供）：这是对标题为“为防止在阿拉斯加吸入使用的社区审判的赠款的竞争续签的重新提交（1 R01 DA015966）。根据NIH审稿人的要求，原始赠款是作为一项可行性研究，要求在5至7年级的阿拉斯加青年开发和试行综合社区预防模型（CPM），以防止使用吸入剂和可摄取的有害法律产品（HLP），以使其高。该模型包括针对零售店，房屋和学校的社区动员和环境战略，以及基于学校的预防课程。由于为期三年的可行性研究，已经开发了干预材料和研究工具，并在四个阿拉斯加社区进行了现场测试。来自参与的阿拉斯加社区成功实施了六个出版物和三个手稿的结果，尽管人们担心它太复杂了。而且，关键结果有足够的变化，以进行全面疗效试验。在此应用程序中，我们建议测试由社区动员（CM）和环境策略（ES）组成的CPM干预措施的凝结版本的功效。 CM策略旨在使社区领导者和团体采取行动。零售店，房屋和学校中的ES解决了有关青年使用HLP，社区采用政策，限制和执行这些政策和限制的社区规范和价值观，以及零售，家庭和学校控制，以减少青年对HLP的机会。基于学校的教育课程已被删除，以降低三部分CPM的复杂性，并将注意力集中在环境策略在防止青年中使用HLP的功效上的功效。在阿拉斯加的16个偏远农村（边境）社区的主要社区领导人已获得了承诺，这些社区主要包含高加索人或阿拉斯加本地人口的混合物。近端结果是并降低阿拉斯加边境社区中使用的HLP的可用性。远端结果是减少社区准备的增加比例，以防止使用HLP的使用，前和早期青少年（第五，6年级，年级），他们打算或确实会在当地零售商店，家庭和学校中发现吸入或摄入HLP。研究设计是一项为期五年的随机对照试验（RCT），其中八对匹配的边境社区将被随机分配到实验和控制条件上。这16个社区位于该州的各个地区，人口规模从536到5,937。这项功效试验将将严格的定量方法与包括社区参与和协作组成的参与性研究原则相结合，以表彰每个研究社区的独特文化和第七遗产。这项研究的意义在于其潜力有效的干预措施，以防止在美国公共卫生相关性的偏远农村和可持续性社区中使用吸入剂和其他有害法律产品：在实验条件下对拟议社区预防模型的测试特别重要，因为在阿拉斯加，西部德克萨斯州，北部或北部的Minesnessota中，几乎没有循证基于证据的预防模型。此外，以吸入剂和其他有害法律产品为目标的基于证据的预防模型甚至更少。此外，关注零售店，房屋和学校的社区动员和环境战略的整合具有创新性，并邀请整个社区承担预防青年药物滥用的责任，而不是假设仅是学校系统的责任。