Snow-Hill Nyssa L, Donenberg Geri, Feil Edward G, Smith David R, Floyd Brenikki R, Leve Craig
Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
Influents Innovations, Eugene, OR, United States.
JMIR Form Res. 2021 Sep 30;5(9):e31185. doi: 10.2196/31185.
Justice-involved youth are especially vulnerable to mental health distress, substance misuse, and risky sexual activity, amplifying the need for evidence-based programs (EBPs). Yet, uptake of EBPs in the justice system is challenging because staff training is costly in time and effort. Hence, justice-involved youth experience increasing health disparities despite the availability of EBPs.
To counter these challenges, this study develops and pilot-tests a prototype of a technology-based training tool that teaches juvenile justice staff to deliver a uniquely tailored EBP for justice-involved youth-PHAT (Preventing HIV/AIDS Among Teens) Life. PHAT Life is a comprehensive sex education, mental health, and substance use EBP collaboratively designed and tested with guidance from key stakeholders and community members. The training tool addresses implementation barriers that impede uptake and sustainment of EBPs, including staff training and support and implementation costs.
Staff (n=11) from two juvenile justice settings pilot-tested the technology-based training tool, which included five modules. Participants completed measures of HIV and sexually transmitted infection (STI) knowledge, sex education confidence, and implementation outcomes such as training satisfaction, adoption, implementation, acceptability, appropriateness, and sustainability. PHAT Life trainers assessed fidelity through two activity role plays participants submitted upon completing the training modules.
Participants demonstrated increases in HIV and STI knowledge (t=3.07; P=.01), and were very satisfied (mean 4.42, SD 0.36) with the training tool and the PHAT Life curriculum. They believed that the training tool and curriculum could be adopted, implemented, and sustained within their settings as an appropriate and acceptable intervention and training.
Overall, the results from this pilot test demonstrate feasibility and support continuing efforts toward completing the training tool and evaluating it within a fully powered randomized controlled trial. Ultimately, this study will provide a scalable option for disseminating an EBP and offers a more cost-effective and sustainable way to train staff in an EBP.
涉司法青少年尤其容易出现心理健康问题、药物滥用和危险性行为,这凸显了对循证项目(EBPs)的需求。然而,在司法系统中采用循证项目具有挑战性,因为员工培训在时间和精力方面成本高昂。因此,尽管有循证项目,涉司法青少年面临的健康差距仍在不断扩大。
为应对这些挑战,本研究开发并试点测试了一种基于技术的培训工具原型,该工具旨在教导少年司法工作人员为涉司法青少年提供一种独特定制的循证项目——PHAT(预防青少年感染艾滋病毒/艾滋病)生活项目。PHAT生活项目是一个综合性的性教育、心理健康和药物使用循证项目,在关键利益相关者和社区成员的指导下进行了协同设计和测试。该培训工具解决了阻碍循证项目采用和持续实施的实施障碍,包括员工培训与支持以及实施成本。
来自两个少年司法机构的11名工作人员对包含五个模块的基于技术的培训工具进行了试点测试。参与者完成了关于艾滋病毒和性传播感染(STI)知识、性教育信心以及培训满意度、采用情况、实施情况、可接受性、适宜性和可持续性等实施结果的测量。PHAT生活项目培训师通过参与者在完成培训模块后提交的两个活动角色扮演来评估保真度。
参与者在艾滋病毒和性传播感染知识方面有所增加(t = 3.07;P = 0.01),并且对培训工具和PHAT生活项目课程非常满意(平均4.42,标准差0.36)。他们认为培训工具和课程可以在其机构内作为一种合适且可接受的干预和培训被采用、实施并持续下去。
总体而言,本次试点测试的结果证明了可行性,并支持继续努力完成培训工具并在全面的随机对照试验中对其进行评估。最终,本研究将为传播循证项目提供一种可扩展的选择,并提供一种更具成本效益和可持续性的方式来培训员工实施循证项目。