Community Randomized Trial in the Cherokee Nation: CONNECT and CMCA for Preventing Drug Misuse among Older Adolescents

切罗基族社区随机试验：CONNECT 和 CMCA 预防老年青少年药物滥用

• 批准号: 10252951
• 负责人: KELLI Ann KOMRO
• 金额: $ 114.16万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10252951
• 关键词: Adolescence; Adolescent; Adolescent and Young Adult; Age; Alcohol consumption; American Indians; Award; Cherokee Indian; Collaborations; Communities; Cost Effectiveness Analysis; Disease; Drug usage; Employee; Funding; Goals; Individual; Institutional Review Boards; Intervention; Measures; Mediator of activation protein; Modeling; Monitor; Multimedia; Oklahoma; Opioid; Outcome; Outcome Measure; Pharmaceutical Preparations; Phase; Population; Prevention; Prevention strategy; Prevention trial; Procedures; Protocols documentation; Public Health; Randomized; Research; Research Personnel; Risk; Rural; Rural Community; Schools; Science; Scientific Advances and Accomplishments; Scientist; Site; Social Network; Social support; Standardization; Structure; Students; Suicide prevention; Surveys; System; Testing; Universities; Youth; alcohol and other drug; base; behavioral health; brief intervention; caucasian American; cohort; community intervention; cost; cost effectiveness; critical developmental period; design; drug abuse prevention; drug misuse; evidence base; follow-up; high risk; high school; implementation cost; implementation fidelity; implementation intervention; implementation measures; implementation process; improved; innovation; marijuana use; misuse of prescription only drugs; opioid epidemic; opioid misuse; prevent; preventive intervention; programs; randomized trial; recruit; screening and brief intervention; staff intervention; success; tenth grade; theories; therapy design; underage drinking; young adult

Abstract The national public health opioid crisis has disproportionately burdened rural white populations, and disproportionately burdened American Indian populations. Therefore, the Cherokee Nation (CN) and Emory University public health scientists have designed an opioid prevention trial to be conducted in at-risk rural communities in the CN (in northeast Oklahoma) with white and American Indian adolescents and young adults. Our goal is to implement and evaluate a theory-based, integrated multi-level community intervention designed to prevent the onset and escalation of opioid and other drug misuse. Two distinct intervention approaches— community organizing as implemented in our established CMCA intervention protocol, and universal school- based brief intervention and referral as implemented in our established CONNECT intervention protocol—will be expanded and integrated to further enhance their effects in preventing and reducing opioid misuse. The CMCA and CONNECT interventions were originally designed to target adolescent alcohol use, but nevertheless showed significant beneficial effects on use of other drugs, including prescription drug misuse. The proposed study will: (1) further improve the design of the interventions with increased focus on opioids, (2) test the expanded, integrated versions in a community randomized trial, and (3) design and test new systems for sustained implementation within existing structures of the Cherokee Nation. Building upon the extant prevention science evidence, our study will respond to a gap in evidence concerning opioid misuse prevention among at-risk adolescents transitioning to young adulthood among American Indian and other rural youth. Our previous trial, conducted in partnership with the Cherokee Nation ended with youth attaining age 18; the proposed new trial will additionally advance the science regarding strategies to engage young adults as they transition beyond high school. During the UG3 planning phase we will (1) expand and integrate a theory-based multi-level preventive intervention package for the critical developmental period of late adolescence to young adulthood, (2) develop implementation, proximal and opioid and other drug use outcome measures, and (3) prepare for the initiation of the trial. During the UH3 trial phase we will (1) implement interventions through Cherokee Nation and measure implementation processes and fidelity, (2) measure proximal and opioid and other drug use outcomes every six months among a cohort of 10th grade students from 16 schools followed over three years through their transition out of high school, (3) test via a community randomized trial the effect of the integrated CMCA-CONNECT intervention, and (4) analyze implementation costs and cost-effectiveness. This trial will expand upon our previous research to substantially advance the scientific evidence regarding prevention of opioid and other drug misuse during the critical developmental period of late adolescent transitions to young adulthood.

抽象的 全国公共卫生阿片类药物危机烧毁了农村白人人群的比例不成比例， 不成比例地烧毁了美洲印第安人人口。因此，切诺基国家（CN）和埃默里（Emory） 大学公共卫生科学家设计了一项阿片类药物预防试验 CN（俄克拉荷马州东北部）的社区与白人和美洲印第安人和年轻人。 我们的目标是实施和评估设计的基于理论的，集成的多层次社区干预设计 为了防止阿片类药物和其他药物滥用的发作和升级。两种不同的干预方法 - 社区组织在我们既定的CMCA干预方案以及普遍学校中实施的组织 - 基于我们已建立的连接干预协议中实施的基于简短的干预和转诊 - 将会 扩展和整合，以进一步增强其在预防和减少阿片类药物滥用方面的影响。这 CMCA和连接干预措施最初是为针对青少年饮酒而设计的，但是 然而，对其他药物的使用（包括处方药滥用）显示出重大的有益作用。 拟议的研究将：（1）进一步改善了对阿片类药物的关注的重点，（2） 在社区随机试验中测试扩展的集成版本，以及（3）设计和测试新系统 为了在切诺基国家的现有结构中持续实施。依据 预防科学证据，我们的研究将回应有关阿片类药物预防的证据的差距 在高危的青少年中，在美洲印第安人和其他粗糙的青年中过渡到年轻成年。我们的 与切诺基国家合作进行的先前审判以年轻人年龄18岁结束；这 拟议的新试验还将进一步推进有关与年轻人一起参与策略的科学 过渡高中。在UG3计划阶段，我们将（1）扩展和整合基于理论的 青少年晚期至Young的关键发展期的多层次预防干预套餐 成年，（2）开发实施，近端和阿片类药物以及其他药物使用结果指标，以及（3） 为审判计划做准备。在UH3试验阶段，我们将（1）通过 切诺基国家和测量实施过程和保真度，（2）近端和阿片类药物的测量 来自16所学校的10年级学生每六个月的其他药物使用成果随后 通过高中过渡到三年以上，（3）通过社区随机试验测试效果 集成的CMCA连接干预措施以及（4）分析实施成本和成本效益。 该试验将扩大我们以前的研究，以大大提高有关的科学证据 在青少年后期的关键发育时期预防阿片类药物和其他药物 过渡到年轻成年。