Implementing Fourth R in US schools: feasibility, fidelity, and sustainability

在美国学校实施 Fourth R：可行性、保真度和可持续性

• 批准号: 9035127
• 负责人: Jeff R Temple
• 金额: $ 34.29万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9035127
• 关键词: Implementing; Fourth; US; schools; feasibility

 DESCRIPTION (provided by applicant): Each year, approximately 25% of US teens sustain physical, psychological, or sexual abuse by dating partners. Many victims of teen dating violence (TDV) experience a host of devastating consequences, including acute and chronic mental and physical health problems, suicidality, delinquency, risky sexual behavior, substance abuse, and academic failure. Moreover, perpetrators of TDV are more likely to perpetrate other forms of violence and are at increased risk for continuing intimate partner violence in adulthood. Although TDV is a pervasive problem, it is largely preventable. One efficacious program, the Fourth R, integrates the promotion of healthy relationship skills and prevention of TDV into existing school curricula. Fourth R components are aligned with state and federal curriculum requirements in health, thus minimizing time and financial burdens placed upon resource-strapped schools. It includes both classroom activities and school-level components in which teachers receive specialized training on teaching about healthy relationships and students form "safe school committees." Fourth R is used in over 5,000 schools in Canada, as well as several sites throughout the United States and Europe, and multiple systematic reviews and national agencies have identified it as one of only a few promising TDV prevention programs. Indeed, Fourth R has been shown to reduce physical TDV perpetration, increase relationship and peer resistance skills, and increase condom use. The effectiveness of Fourth R has been especially pronounced among high-risk youth. Developing an efficacious prevention program such as the Fourth R is only part of the equation. Implementing the program in real-world settings with fidelity and sustainability is the other, perhaps more difficult, part. Thus, prior to the Fourth R undergoing widespread dissemination and implementation, it is crucial to understand how factors at the school, teacher, and student levels affect program feasibility, fidelity, and sustainability. Also of interest is how this Canadian program is translated and adapted for use in US urban, suburban, and rural high schools. We propose to train teachers to implement Fourth R with 4 successive cohorts of 9th-grade students in 10 ethnically, economically, and geographically diverse high schools in Texas. The primary aims of this implementation study, which will use a mixed methods design, are to (1) assess initial feasibility, quality, acceptabilit, engagement, adaptation, and satisfaction with Fourth R, (2) examine school-, teacher-, and student-level barriers to high-fidelity implementation and correlates of low fidelity to the intervention protocol, (3) determine sustainability and impact of experience on implementation by assessing changes over the course of the study in fidelity, feasibility, acceptability, satisfaction, and engagement, and (4) evaluate effects of initial implementation fidelity and change over time on students' changes in attitudes, knowledge, skills, intentions, and behavior related to teen dating violence.

 描述（由申请人提供）：每年，大约 25% 的美国青少年遭受约会对象的身体、心理或性虐待，许多青少年约会暴力 (TDV) 的受害者经历了一系列毁灭性后果，包括急性和慢性精神和性虐待。此外，TDV 的肇事者更有可能实施其他形式的暴力，并且在成年后遭受亲密伴侣暴力的风险也更高。 TDV 是一个普遍存在的问题，它在很大程度上是可以预防的，第四 R 计划将促进健康关系技能和预防 TDV 纳入现有的学校课程中，并且与州和联邦健康课程要求保持一致。最大限度地减少资源匮乏的学校的时间和经济负担。它包括课堂活动和学校层面的部分，其中教师接受有关健康关系教学的专门培训，并且学生组成“安全学校委员会”。加拿大的 5,000 所学校以及美国和欧洲的多个地点以及多个系统审查和国家机构已将其确定为少数有前途的 TDV 预防计划之一。 事实上，Fourth R 已被证明可以减少实际 TDV 犯罪。提高人际关系和同伴抵抗能力，并增加安全套的使用，这在高危青少年中尤其明显。制定像 Fourth R 这样的有效预防计划只是实际实施该计划的一部分。 -世界因此，在第四个 R 之前，保真度和可持续性的设置是另一个部分，也许更困难。 随着该项目的广泛传播和实施，了解学校、教师和学生层面的因素如何影响项目的可行性、保真度和可持续性至关重要。同样令人感兴趣的是这个加拿大项目如何被翻译和调整以供在美国城市和郊区使用。我们建议对德克萨斯州 10 所种族、经济和地理位置不同的高中的 4 批 9 年级学生进行培训，以实施 Fourth R。混合方法设计，是(1) 评估第四 R 的初步可行性、质量、可接受性、参与度、适应度和满意度，(2) 检查学校、教师和学生层面对高保真度实施的障碍以及低保真度与干预的相关性协议，(3) 通过评估研究过程中保真度、可行性、可接受性、满意度和参与度的变化来确定经验对实施的可持续性和影响，以及 (4) 评估初始实施保真度和随时间变化对学生的影响' 态度、知识、技能、意图的变化，以及与青少年约会暴力相关的行为。