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

基本信息

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
项目类别：
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

项目摘要

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给农村白人带来了不成比例的负担，因此，切罗基民族（CN）和埃默里的印第安人负担过重。大学公共卫生科学家设计了一项阿片类药物预防试验，将在高危农村地区进行 CN（俄克拉荷马州东北部）的白人和美洲印第安人青少年和年轻人社区。我们的目标是实施和评估基于理论的综合多层次社区干预措施为了防止阿片类药物和其他药物滥用的发生和升级，两种不同的干预方法 - 我们制定的 CMCA 干预协议中实施的社区组织和普及学校- 基于我们既定的 CONNECT 干预协议中实施的简短干预和转介——将扩大和整合，以进一步增强其预防和减少阿片类药物滥用的效果。 CMCA 和 CONNECT 干预措施最初旨在针对青少年饮酒，但然而，对其他药物的使用，包括处方药的滥用，显示出显着的有益影响。拟议的研究将：(1) 进一步改进干预措施的设计，更加关注阿片类药物，(2) 在社区随机试验中测试扩展的集成版本，以及 (3) 设计和测试新系统在切罗基族现有结构内持续实施。预防科学证据，我们的研究将回应有关阿片类药物滥用预防的证据空白美洲印第安人和其他农村青年中的高危青少年。之前与 Cherokee Nation 合作进行的试验以年满 18 岁的青少年结束；拟议的新试验还将进一步推进有关吸引年轻人参与的策略的科学在 UG3 规划阶段，我们将 (1) 扩展和整合基于理论的课程。针对青春期后期至青少年关键发育期的多层次预防干预方案成年期，(2) 制定实施、近端和阿片类药物及其他药物使用结果措施，以及 (3) 为试验的启动做好准备在 UH3 试验阶段，我们将 (1) 通过以下方式实施干预措施。切罗基民族并测量实施流程和保真度，(2) 测量近端阿片类药物和每六个月对来自 16 所学校的一组 10 年级学生进行其他药物使用结果跟踪高中毕业三年内，(3) 通过社区随机试验测试效果 (4) 分析实施成本和成本效益。这项试验将扩展我们之前的研究，以实质性地推进有关以下方面的科学证据：预防青春期后期关键发育时期阿片类药物和其他药物的滥用过渡到青年时期。