Cherokee Nation Prevention Trial: Interactive Effects of Environment & SBIRT

切罗基族预防试验：环境的交互影响

基本信息

批准号：
8868210
负责人：
KELLI Ann KOMRO
金额：
$ 9.98万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-15 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8868210
关键词：
Accident and Emergency department Address Adolescent Age Alcohol consumption Alcohols American Indians Area Cherokee Indian Clinic Clinical Trials Design Communities Community Actions Community Trial Country Data Collection Diffusion Disadvantaged Drug Addiction Effectiveness Elements Environment Evaluation Family Family history of Future Gatekeeping Gender Goals Health Services Health Services for the Aged High School Student Individual Information Systems Internet Intervention Intervention Studies Lead Leadership Life Measurement Measures Media Campaign Mentors Mentorship Methods Modeling Oklahoma Outcome Outcome Measure Participant Population Poverty Prevention Prevention Research Preventive Preventive Intervention Protocols documentation Random Allocation Records Research Research Design Research Personnel Research Project Grants Risk Risk Factors Rural Rural Community Sampling Sampling Studies Schools Science Scientist Series Socioeconomic Status Source Survey Methodology Surveys System Technology Testing Time Training United States National Institutes of Health Work Youth alcohol availability alcohol prevention base behavioral health brief intervention cohort community based participatory research community intervention comparison group control trial cost data management design environmental change environmental intervention evidence base health disparity high risk innovation intervention effect motivational enhancement therapy peer programs randomized trial research study screening screening and brief intervention screening, brief intervention, referral, and treatment social socioeconomics therapy design underage drinking underage drinking prevention youth access to alcohol

项目摘要

DESCRIPTION (provided by applicant): The proposed project is a partnership between prevention scientists and the Cherokee Nation Behavioral Health Services to create, implement and evaluate a new, integrated community-level intervention designed to prevent underage drinking and associated negative consequences among American Indian and white youth living in rural high-risk underserved communities. This trial will take place in northeastern Oklahoma, an area suffering from high rates of poverty and substantial health disparities. The proposed intervention builds directly on the results of multiple previous experiments with two distinct approaches-community environmental change and brief intervention and referral-evaluated alone and in combination using a factorial design. Direct- action community organizing, documented as effective in multiple previous randomized trials, will be used to address community issues related to alcohol use and commercial and social access to alcohol among adolescents. Our design and implementation of brief interventions differs in a fundamental way from typical implementations. Instead of SBIRT implemented in select limited numbers of clinics, emergency departments or schools, we will design a community-wide SBIRT intervention. The population-level brief interventions will include five key components: (1) brief one-on-one screening and motivational interviewing sessions, (2) gatekeeper training, (3) peer leader training, (4) family postcard campaign, and (5) community-wide media campaign. Five key research design elements optimize causal inference and experimental evaluation of the intervention effects: (1) a controlled interrupted time-series design, (2) random selection of towns, (3) random assignment to study condition, (4) a factorial design, and (5) multiple comparison groups. The primary design feature of this randomized trial is a controlled interrupted time-series design. The large number of repeated measures (a time-series) substantially increases internal validity (i.e., strength of causal inference) as well as statistical power over conventional pre/post community trial designs. Repeated assessments will measure implementation fidelity for each intervention component, and measure key proximal as well as the primary ultimate outcomes through survey, observation and archival sources. The primary study sample will include all high-school students within study towns. Weekly and monthly measurements will produce a time-series design with observations of youth nested within town over the four-year period. In addition to repeated cross-sectional samples, we will use participant identifiers to track the embedded cohorts over the four years. This innovative project, involving a strong partnership between established prevention scientists and leaders of the Cherokee Nation Behavioral Health Services, has the potential to transform alcohol prevention research and practice. Despite advances in prevention science and practices in recent decades, the U.S. continues to struggle with significant alcohol-related risks and consequences among youth. The proposed project will provide a rigorous evaluation of a new, integrated community-level preventive intervention.

描述（由申请人提供）：拟议的项目是预防科学家与切诺基国家行为卫生服务之间的合作伙伴关系，以创建，实施和评估旨在防止未成年人饮酒和相关的负面后果的新的，整合的社区级干预措施，居住在农村高危社区中的美洲印第安人和白人青年。该试验将在俄克拉荷马州东北部举行，俄克拉荷马州的贫困率很高，健康差异很大。提出的干预措施直接建立在多个先前实验的结果基础上，其两种不同的方法社区环境变化和简短的干预措施，并使用阶乘设计单独进行转介评估。直接行动社区组织在多个先前的随机试验中有效记录，将用于解决青少年中与酒精使用以及商业和社交饮酒有关的社区问题。我们的设计和简短干预措施的设计和实施与典型的实施方式不同。我们将设计社区范围内的SBIRT干预措施，而不是在有限数量的诊所，急诊科或学校中实施的SBIRT。人口级的简短干预措施将包括五个关键组成部分：（1）简短的一对一筛查和动机访谈课程，（2）看门人培训，（3）同伴领导者培训，（4）家庭明信片运动和（5）社区范围内的媒体运动。五个关键的研究设计要素优化了因果推断和对干预效果的实验评估：（1）受控中断的时间序列设计，（2）城镇的随机选择，（3）随机分配研究条件，（4）阶乘设计和（5）多个比较组。这项随机试验的主要设计特征是受控中断的时间序列设计。大量的重复度量（时间序列）大大提高了内部有效性（即因果推理的强度）以及对常规固定前/社区后试验设计的统计能力。重复评估将衡量每个干预部分的实施保真度，并通过调查，观察和档案来源来衡量关键近端以及主要的最终结果。主要的研究样本将包括学习城镇中的所有高中生。每周和每月的测量将产生时间序列设计，并在四年期间对城镇内嵌套的青年进行观察。除了重复的横截面样本外，我们还将使用参与者标识符在四年中跟踪嵌入式人群。这个创新的项目涉及既定的预防科学家与切诺基国家行为卫生服务的领导者之间的牢固伙伴关系，具有改变酒精预防研究和实践的潜力。尽管近几十年来预防科学和实践取得了进步，但美国仍在为与酒精有关的风险和后果造成的斗争。拟议的项目将对新的综合社区级预防干预进行严格评估。