Sánchez Victoria, Steckler Allan, Nitirat P, Hallfors D, Cho H, Brodish P
Pacific Institute for Research and Evaluation, Chapel Hill Center, NC 27514, USA.
Health Educ Res. 2007 Feb;22(1):95-107. doi: 10.1093/her/cyl052. Epub 2006 Jun 28.
In 'a treatment effectiveness trial', a program is evaluated in a real-world setting, with an emphasis on achieving high implementation fidelity. Through fidelity assessment, the link between program implementation and outcomes is systematically evaluated and ultimately leads to a greater understanding of program success or failure. This paper reports the results of an implementation fidelity study of the 'Reconnecting Youth' (RY) prevention program. The research questions were (i) was the program implemented with fidelity? and (ii) did better fidelity predict better outcomes? RY is an indicated drug abuse prevention program for high school students that seeks to 'reconnect' high-risk youth to school before they drop out. The results reported here were part of a randomized controlled effectiveness trial of the RY prevention program conducted in two urban school districts in which 15 teachers taught 41 RY classes. Overall, implementation fidelity was high with an average 90% of core lessons being taught. Unexpectedly, increased quality of implementation predicted increased alcohol use and anger. Adherence (teaching more of the curriculum) predicted increased marijuana use, while exposure (student attendance) significantly increased bonding to high-risk peers, alcohol use and anger.
在“一项治疗效果试验”中，一个项目在现实环境中进行评估，重点是实现高实施保真度。通过保真度评估，系统地评估项目实施与结果之间的联系，并最终加深对项目成功或失败的理解。本文报告了“重新联结青年”（RY）预防项目的实施保真度研究结果。研究问题是：（i）该项目是否保真实施？（ii）更高的保真度是否预示着更好的结果？RY是一项针对高中生的指定药物滥用预防项目，旨在让高危青年在辍学之前“重新联结”到学校。这里报告的结果是在两个城市学区进行的RY预防项目随机对照效果试验的一部分，其中15名教师教授了41节RY课程。总体而言，实施保真度很高，平均90%的核心课程都有讲授。出乎意料的是，实施质量的提高预示着酒精使用和愤怒情绪的增加。坚持性（讲授更多课程内容）预示着大麻使用的增加，而参与度（学生出勤情况）显著增加了与高危同伴的联系、酒精使用和愤怒情绪。
