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剖析青少年酒精预防的多组分方法:“北国计划”中哪些措施起了作用?

Teasing apart a multiple component approach to adolescent alcohol prevention: what worked in Project Northland?

作者信息

Stigler Melissa H, Perry Cheryl L, Komro Kelli A, Cudeck Robert, Williams Carolyn L

机构信息

Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.

出版信息

Prev Sci. 2006 Sep;7(3):269-80. doi: 10.1007/s11121-006-0040-7.

Abstract

This paper presents the results of a post hoc component analysis designed to tease apart the effects of different intervention strategies used in Project Northland, a group-randomized, community-wide, multi-level intervention trial originally conducted in the 1990's to prevent and reduce alcohol use among a cohort of mainly White students in rural Minnesota. This study focuses on Phase I, when students were in 6th-8th grade. The intervention during this phase included five components: classroom curricula, peer leadership, youth-driven/led extra-curricular activities, parent involvement programs, and community activism. Student exposure to/participation in these components was followed over time using reliable process measures. These measures were used as time-varying covariates in growth curve analyses to estimate the effects of the intervention components over time. Multi-item scales from annually-administered student surveys were used to measure relevant outcome variables, like alcohol use. The impact of the components appears to have been differential. The strongest effects were documented for the planners of extra-curricular activities and parent program components. The classroom curricula proved moderately effective, but no effects were associated with differential levels of community activism. The interactions tested here did not provide support for synergistic effects between selected intervention components. Care must be taken when selecting and combining intervention strategies meant to reduce adolescent alcohol use.

摘要

本文介绍了一项事后成分分析的结果,该分析旨在梳理出在“北国计划”中所采用的不同干预策略的效果。“北国计划”是一项群组随机、覆盖整个社区的多层次干预试验,最初于20世纪90年代开展,旨在预防和减少明尼苏达州农村地区一群主要为白人的学生的酒精使用情况。本研究聚焦于第一阶段,即学生处于六年级至八年级期间。该阶段的干预包括五个部分:课堂课程、同伴领导力、青少年主导的课外活动、家长参与计划以及社区行动主义。随着时间的推移,通过可靠的过程测量方法跟踪学生对这些部分的接触/参与情况。这些测量方法在生长曲线分析中被用作随时间变化的协变量,以估计干预各部分随时间的效果。每年进行的学生调查中的多项目量表被用于测量相关的结果变量,如酒精使用情况。各部分的影响似乎有所不同。课外活动规划者和家长计划部分的效果最为显著。课堂课程被证明有一定效果,但社区行动主义的不同程度并未产生影响。此处测试的相互作用并未为所选干预部分之间的协同效应提供支持。在选择和组合旨在减少青少年酒精使用的干预策略时必须谨慎。

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