Native iCHAMPS: An Innovative Online Decision Support System for Increasing Implementation of Effective Sexual Health Education in Tribal Communities

Native iCHAMPS：一种创新的在线决策支持系统，用于在部落社区加强有效的性健康教育的实施

• 批准号: 10092216
• 负责人: Christine Margaret Markham
• 金额: $ 19.4万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092216
• 关键词: Address; Adopted; Adoption; Alaska Native; American Indians; Area; Arizona; Attitude; Birth Rate; Communities; Decision Support Systems; Development; Dissemination and Implementation; Education; Educational Intervention; Effectiveness; Ethnic group; Evidence based intervention; Geography; Goals; HIV; HIV Infections; Health; Health Educators; Health Promotion; Health education; Human Resources; Individual; Internet; Knowledge; Logistics; Maintenance; Modeling; Organizational Policy; Population; Pregnancy in Adolescence; Prevention education; Process; Randomized; Randomized Controlled Trials; Readiness; Reproductive Health; Research; Resources; Sampling; Schools; Self Efficacy; Sex Education; Sexual Health; Sexually Transmitted Diseases; Site; Texas; Training; Translating; Tribal Council; Universities; base; design; digital; disparity reduction; effectiveness evaluation; experience; health disparity; high risk; implementation barriers; implementation process; implementation strategy; innovation; intervention mapping; native youth; population health; pregnancy prevention; programs; racial and ethnic; teen birth; theories; tool; tribal community; tribal health; uptake; usability

Native iCHAMPS: An Innovative Online Decision Support System for Increasing Implementation of Effective Sexual Health Education in Tribal Communities ABSTRACT American Indian and Alaska Native (AIAN) youth experience serious disparities in sexual and reproductive health. These disparities may be ameliorated by the implementation of effective sexual health education. Yet, multiple factors, such as lack of access to culturally-relevant evidence-based interventions (EBIs), limited trained personnel, cultural barriers, and geographic isolation, hinder the adoption and implementation of effective sexual health EBIs in tribal communities. The goal of this R21 study is to adapt and assess the feasibility of an innovative online decision support system (DSS), Native iCHAMPS, as an effective implementation strategy to facilitate the adoption and implementation of sexual health EBIs in AIAN communities. We propose to adapt iCHAMPSS (CHoosing And Maintaining Effective Programs for Sex Education in Schools), a theory-based, online DSS developed by our research team to increase uptake and implementation of sexual health EBIs in Texas schools. Grounded in dissemination and implementation (D&I) theories, iCHAMPSS comprises 60+ tools to provide step-by-step guidance to overcome D&I barriers for sexual health education. Shown to impact critical determinants of EBI adoption and implementation and to mobilize school personnel to obtain board approval and implement a sexual health EBI, iCHAMPSS serves as an excellent implementation strategy to adapt for AIAN communities. AIAN stakeholders (n=35) rated iCHAMPSS as acceptable, easy to use, credible, appealing, and more helpful than current resources for EBI adoption and implementation in AIAN communities. Yet, because iCHAMPSS was designed specifically for Texas schools, the underlying DI& processes may not adequately reflect D&I processes in AIAN communities. Indeed, AIAN stakeholders recommended adaptations to iCHAMPSS to better reflect the needs and values of tribal communities. Our long-term goal is to reduce teen pregnancy, STI/HIV among AIAN youth by increasing the adoption, implementation, and maintenance of culturally-relevant sexual health EBIs in AIAN communities. In this R21 study, we propose to adapt the existing iCHAMPSS conceptual model and DSS to address barriers and facilitators to the adoption, implementation, and maintenance of sexual health education EBIs in AIAN communities (Native iCHAMPS), identify strategies to optimize its adoption and implementation, and assess the feasibility and impact of adopting and implementing Native iCHAMPS among a sample of heterogeneous and geographically disparate AIAN stakeholders (n=45) across the U.S. The study is innovative as it informs a culturally relevant, conceptual D&I model for sexual health EBIs in AIAN communities, and translates that model as a practical cross-platform digital DSS (Native iCHAMPS) to increase D&I capacity in geographically isolated, low-resource AIAN communities. It is significant because it advances use of culturally-relevant sexual health EBIs, thus impacting population health for underserved, high-risk AIAN youth. Findings will inform a randomized multisite R01 trial to assess the effectiveness of Native iCHAMPS in AIAN communities.

本地Ichamps：一种创新的在线决策支持系统 在部落社区实施有效的性健康教育 抽象的 美洲印第安人和阿拉斯加人（Aian）青年在性和生殖方面经历了严重的差异 健康。实施有效的性健康教育可能会改善这些差异。然而， 多种因素，例如无法获得与文化相关的循证干预措施（EBIS），有限 受过训练的人员，文化障碍和地理隔离，阻碍了采用和实施 部落社区的有效性健康EBI。这项R21研究的目的是适应和评估 创新的在线决策支持系统（DSS），本地ICHAMP的可行性，有效 实施策略，以促进Aian采用和实施性健康EBI 社区。我们建议适应Ichampss（选择和维护性爱有效计划 学校教育），我们的研究团队开发的基于理论的在线DSS，以增加吸收和 在德克萨斯学校实施性健康EBI。基于传播和实施（D＆I） 理论，Ichampss包括60多个工具，可提供分步指南，以克服D＆I的障碍 性健康教育。证明会影响EBI采用和实施的关键决定因素以及 动员学校人员获得董事会批准并实施性健康EBI，Ichampss作为 适应艾安社区的出色实施策略。 Aian利益相关者（n = 35）等级 与当前的EBI资源相比 在艾安社区的收养和实施。但是，因为Ichamps是专门设计的 德克萨斯州的学校，基本的DI和流程可能无法充分反映Aian社区的D＆I流程。 实际上，艾安利益相关者建议对Ichampss进行改编，以更好地反映 部落社区。我们的长期目标是通过增加青少年怀孕，艾安青年的性病/艾滋病毒 艾安社区中与文化健康相关的性健康EBI的采用，实施和维护。 在这项R21研究中，我们建议适应现有的ICHAMPS概念模型和DSS来解决障碍 以及在艾安（Aian）采用，实施和维持性健康教育EBI的促进者 社区（本地ICHAMP），确定优化其采用和实施的策略，并评估 在异质样本中采用和实施本地iChamp的可行性和影响 以及美国各地的地理上不同的利益相关者（n = 45），这项研究具有创新性，因为它告知了A 在艾安社区中，具有文化相关的，概念性的D＆I模型，并将其翻译 模型作为实用的跨平台数字DSS（本地ICHAMP），以提高地理上的D＆I能力 孤立的，低资源的Aian社区。这很重要，因为它可以推进与文化相关的使用 性健康EBI，从而影响了服务不足的高风险Aian青年的人口健康。调查结果会 通知一项随机的多站点R01试验，以评估本地ICHAMP在Aian社区的有效性。

项目成果

The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping to adapt an online decision support system to promote culturally-relevant sexual health education for American Indian and Alaska Native youth.

• DOI: 10.3389/fpubh.2022.889924
• 发表时间: 2022
• 期刊: Frontiers in public health
• 影响因子: 5.2
• 作者: Markham CM;Rushing SC;Manthei J;Singer M;Jessen C;Gorman G;Peskin MF;Hernandez BF;Sacca L;Evans GS;Luna-Meza C;Merritt Z;Shegog R
• 通讯作者: Shegog R

Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in indigenous communities: a scoping review.

• DOI: 10.1186/s13012-022-01190-y
• 发表时间: 2022-02-21
• 期刊: Implementation science : IS
• 作者: Sacca L;Shegog R;Hernandez B;Peskin M;Rushing SC;Jessen C;Lane T;Markham C
• 通讯作者: Markham C