A Collaborative System Approach for the Diffusion of Evidence-Based Prevention

传播循证预防的协作系统方法

• 批准号: 8231650
• 负责人: GILBERT J BOTVIN
• 金额: $ 2.7万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8231650
• 关键词: ATOD; Address; Adolescence; Adoption; Affect; Alcohol abuse; Alcohols; Americas; Cataloging; Catalogs; Clinical Trials Design; Communities; Development; Development Plans; Diffusion; Drug abuse; Drug usage; Effectiveness; Evaluation Studies; Evidence based program; Gender; Goals; Health; Illicit Drugs; Intervention; Knowledge; Lead; Life; Maps; Methodology; Methods; Modeling; NIH Program Announcements; New York; New York City; Outcome; Phase; Prevention; Prevention program; Process; Program Effectiveness; Randomized; Relative (related person); Research; Research Personnel; Scientist; Services; Structure; Students; Support System; System; Testing; Thinking; Tobacco; Training Programs; United States; Work; Youth; alcohol and other drug; base; college; design; dissemination research; drug abuse prevention; evidence base; expectation; experience; falls; flexibility; human ecology; implementation research; medical schools; middle school; organizational structure; prevent; programs; racial and ethnic; randomized trial; skills training; theories; tobacco abuse

DESCRIPTION (provided by applicant): The proposed research is a revised application responding to program announcement PAR-06-039 entitled "Dissemination and Implementation Research in Health." More than two decades of research have produced evidence-based approaches for preventing tobacco, alcohol, and other drugs during adolescence. New research is urgently needed to identify, develop, and refine effective and efficient methods, structures, and strategies that test models to disseminate and implement evidence-based prevention. The proposed research is designed to test the extent to which collaborative and adaptive systems-based approaches and structures will be effective at promoting the dissemination, adoption, implementation, and sustainability (DAIS) of evidence-based tobacco, alcohol, and drug abuse prevention. This study will assess the relative benefits of a systems-based adaptation-focused implementation effort versus a traditional ("top- down") fidelity-focused one. The term system is used to refer both to the methodologies we will employ in developing DAIS efforts and to the organizational structures we will engage to support these efforts. Collaborative systems thinking methodologies will be used to design and manage DAIS efforts, and the system structure of the Cooperative Extension System (CES) will be used to support implementation. During Phase I (24 months), a systems methodology (concept mapping) will be utilized to enable the stakeholder community to identify key factors in the DAIS of evidence-based prevention in general, and facilitate the development of a systems approach to implementation of a specific evidence-based prevention program, Life Skills Training (LST). The systems approach will utilize concept mapping, adaptive systems thinking methods, and CES as the organizational support structure. Phases II (30 months) will consist of a randomized trial during which 50 middle schools including 4,000 participating students will be randomly assigned to one of the following conditions: (1) collaborative systems-based adaptive approach to implementation of LST and (2) standard fidelity-focused implementation of LST. The project will be conducted by an experienced team of scientists and staff from Cornell's Weill Medical College in New York City, Cornell's College of Human Ecology in Ithaca, and Cornell's Cooperative Extension Service located throughout New York State. The ultimate goal of the proposed research is to provide critical new knowledge to facilitate the widespread dissemination, adoption, implementation, and sustained utilization of evidence-based prevention in order to reduce tobacco, alcohol, and illicit drug abuse throughout the United States. PUBLIC HEALTH RELEVANCE: Considerable progress has been made in developing effective approaches to prevent tobacco, alcohol, and illicit drug use. However, these approaches have not been widely disseminated and utilized. The ultimate goal of the proposed research is to provide critical new knowledge to facilitate the widespread dissemination, adoption, implementation, and sustained utilization of evidence-based prevention in order to reduce tobacco, alcohol, and illicit drug abuse throughout the United States.

描述（由申请人提供）：拟议的研究是响应计划公告 PAR-06-039 的修订申请，题为“健康领域的传播和实施研究”。二十多年的研究已经产生了基于证据的方法来预防青春期吸烟、酗酒和其他药物。迫切需要新的研究来确定、开发和完善有效且高效的方法、结构和策略，以测试传播和实施循证预防的模型。拟议的研究旨在测试基于协作和适应性系统的方法和结构在多大程度上有效促进基于证据的烟草、酒精和药物滥用预防的传播、采用、实施和可持续性（DAIS）。这项研究将评估基于系统的以适应为重点的实施工作与传统（“自上而下”）以保真度为重点的实施工作的相对效益。术语“系统”既指我们在开发 DAIS 工作时采用的方法，也指我们为支持这些工作而采用的组织结构。协作系统思维方法将用于设计和管理 DAIS 工作，合作推广系统（CES）的系统结构将用于支持实施。在第一阶段（24 个月）期间，将利用系统方法（概念图）使利益相关者群体能够总体上确定基于证据的预防 DAIS 中的关键因素，并促进开发系统方法来实施具体的循证预防计划，生活技能培训（LST）。系统方法将利用概念图、自适应系统思维方法和 CES 作为组织支持结构。第二阶段（30 个月）将包括一项随机试验，其中 50 所中学（包括 4,000 名参与学生）将被随机分配到以下条件之一：（1）基于协作系统的适应性方法实施 LST 和（2）标准以保真度为中心的 LST 实施。该项目将由来自纽约市康奈尔大学威尔医学院、伊萨卡康奈尔大学人类生态学院以及遍布纽约州的康奈尔大学合作推广服务中心的经验丰富的科学家和工作人员团队进行。拟议研究的最终目标是提供重要的新知识，以促进循证预防的广泛传播、采用、实施和持续利用，从而减少全美范围内的烟草、酒精和非法药物滥用。公共卫生相关性：在制定有效的方法来预防烟草、酒精和非法药物的使用方面已经取得了相当大的进展。然而，这些方法尚未得到广泛传播和利用。拟议研究的最终目标是提供重要的新知识，以促进循证预防的广泛传播、采用、实施和持续利用，从而减少全美范围内的烟草、酒精和非法药物滥用。