Preparing to Run Effective Prevention
Condition: Implementation of Evidence Based Programs
Study type: Interventional

Summary: 
      Young people can engage in a variety of negative behaviors-such as drug use, underage
      drinking, and premarital sex-that exact a high toll on local communities. These activities
      are often the target of community-based prevention efforts. Getting To Outcomes (GTO) is an
      approach that includes a toolkit, technical assistance, and training, organized around a
      10-step process, that helps communities plan, implement, and evaluate the impact of their
      programs that attempt to prevent these negative behaviors. This study will examine the degree
      to which Getting To Outcomes helps Boys and Girls Clubs implement an evidence based drug
      prevention program.
    

Detailed description: 
      As a nation, the U.S. invests heavily in community-based organizations to conduct
      interventions, proven through research, to reduce the high rates of alcohol and drug use
      among teens. Much less is invested in helping communities implement these programs with
      quality. Although many evidence-based programs exist to address alcohol and drug use,
      communities face difficulty implementing them and achieving the same outcomes as researchers.
      This "gap" is because resources are limited, prevention is complex, and communities often
      lack the capacity-or the knowledge, attitudes, and skills-needed to implement "off the shelf"
      programs well. Common ways to bridge this gap, such as information dissemination, fail to
      change practice or outcomes at the local level in part because it does not sufficiently
      address capacity of community practitioners. Therefore, building a community's capacity is a
      method that could improve the quality of implementation and outcomes. Getting To Outcomes
      (GTO) is an implementation support intervention shown to improve the capacity of
      practitioners to conduct evidence-based programs, but its impact on fidelity and youth
      outcomes has not been studied. The study-Preparing to Run Effective Prevention (PREP)-will be
      a cluster randomized controlled trial using primary data from middle school youth (990) and
      program staff from 33 cooperating Boys and Girls Clubs sites (Sites) to assess how GTO
      impacts the fidelity, outcomes, and costs of an evidence-based program to prevent alcohol and
      drug use (Project CHOICE, PC). All 33 sites will receive training in PC. 16 Sites will
      conduct PC in a way typical of community-based organizations (PC only); 17 Sites will conduct
      PC augmented by GTO, comprised of training, onsite technical assistance, and a written GTO
      manual. The study will: (1) Assess the use of GTO and compare Sites' capacity between PC+GTO
      and PC only; (2) Compare PC fidelity between PC+GTO and PC only groups; (3) Compare alcohol
      and marijuana outcomes of middle-school youth in the PC+GTO (n=510) and PC only (n=480)
      groups; and (4) Assess the cost-effectiveness of GTO' impact. To address these aims we will
      collect data on the delivery and utilization of GTO (e.g., method of delivery, duration,
      topics); staff capacity to implement research-based interventions; observations of program
      delivery (fidelity monitoring); youth participants' use of, and attitudes towards, alcohol
      and marijuana via a survey at baseline and 3 and 6 months follow-up; and costs of both PC
      alone and PC+GTO. Analyses will examine differences between intervention (PC+GTO) and control
      (PC only) Sites' capacity, PC fidelity, outcomes, and costs over time, accounting for
      clustering within site. The PREP study could expand implementation research and serve as a
      model for how the government and other agencies support strong implementation of
      evidence-based programs in a wide array of domains. These outcomes are important to providing
      opportunities for youth to become healthy and productive adults.
    

Intervention name(s): Getting To Outcomes; Project CHOICE
Intervention type(s): Behavioral; Behavioral
Intervention description(s): These sites will receive written materials, training, and on site technical assistance to use the Getting To Outcomes process to implement Project CHOICE at their sites.; Sites will receive standard training for Project CHOICE.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Prevention