Division of Kinesiology, Health, and Sport Studies, College of Education, Wayne State University, Detroit, MI 48202 USA.
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA.
Transl Behav Med. 2024 Sep 3;14(9):537-548. doi: 10.1093/tbm/ibae038.
Schools frequently adopt new interventions for each new public health issue, but this is both time- and resource-intensive. Adversity exposure is an example of a pervasive public health issue that emerged during Coronavirus Disease 2019 (COVID-19) with notable consequences, including an elevated risk of developing substance use disorders and mental illnesses. Adapting existing, universal, evidence-based interventions, such as the Michigan Model for HealthTM (MMH), by incorporating trauma-sensitive content is a promising approach to meet this need. We examined critical steps in promoting MMH adaptability as part of the Enhanced REP (Replicating Effective Programs) implementation strategy during the COVID-19 pandemic. We share usability testing from the 2020 to 2021 school year and describe how we apply the results to inform the group randomized trial pilot study. We applied key steps from implementation adaptation frameworks to integrate trauma-sensitive content as COVID-19 unfolded, documenting the process through field notes. We conducted initial usability testing with two teachers via interviews and used a rapid qualitative analysis approach. We conducted member checking by sharing the information with two health coordinators to validate results and inform additional curriculum refinement. We developed an adapted MMH curriculum to include trauma-sensitive content, with adaptations primarily centered on adding content, tailoring content, substituting content, and repeating/reinforcing elements across units. We designed adaptations to retain the core functional elements of MMH. Building foundational relationships and infrastructure supports opportunities to user-test intervention materials for Enhanced REP that enhance utility and relevance for populations that would most benefit. Enhanced REP is a promising strategy to use an existing evidence-based intervention to meet better the needs of youth exposed to adversity. Building on the foundations of existing evidence-based interventions, is vital to implementation success and achieving desired public health outcomes.
学校经常针对每个新的公共卫生问题采用新的干预措施，但这既费时又费资源。逆境暴露就是一个例子，它是 2019 年冠状病毒病（COVID-19）期间出现的一个普遍存在的公共卫生问题，其后果显著，包括增加患物质使用障碍和精神疾病的风险。通过纳入创伤敏感内容来改编现有的、普遍的、基于证据的干预措施，如密歇根健康模式（MMH），是满足这一需求的一种有前途的方法。我们研究了在 COVID-19 大流行期间作为增强 REP（复制有效计划）实施策略的一部分促进 MMH 适应性的关键步骤。我们分享了 2020 年至 2021 学年的可用性测试，并描述了如何应用结果为群体随机试验试点研究提供信息。我们应用实施适应性框架中的关键步骤，在 COVID-19 期间整合创伤敏感内容，通过现场记录记录这一过程。我们通过访谈对两位教师进行了初步的可用性测试，并使用快速定性分析方法。我们通过与两位健康协调员分享信息来进行成员检查，以验证结果并为进一步的课程细化提供信息。我们开发了一个改编的 MMH 课程，包括创伤敏感内容，主要的改编集中在添加内容、定制内容、替代内容和在单元之间重复/强化元素。我们设计了改编，以保留 MMH 的核心功能要素。建立基础关系和基础设施支持机会，对增强 REP 的干预材料进行用户测试，以提高对最受益人群的实用性和相关性。增强 REP 是一种利用现有基于证据的干预措施更好地满足暴露于逆境的年轻人需求的有前途的策略。在现有基于证据的干预措施的基础上进行构建，对于实施成功和实现预期的公共卫生结果至关重要。
