Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study

This study examined how teachers discuss various factors as impacting their ability to execute with fidelity the Michigan Model for Health (MMH), an evidence-based health universal prevention curriculum widely adopted throughout Michigan. Researchers have found a robust relationship between fidelity and participant outcomes, including in schools. While previous studies have identified barriers that inhibit fidelity, few have focused on identifying key barriers and deepening our understanding of how these factors influence intervention fidelity. We conducted a thematic analysis using the reflexive thematic approach to identify key barriers and facilitators and deepen our understanding of how these factors influence MMH implementation. Guided by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcomes Framework, we conducted semistructured interviews with 23 high school health teachers across Michigan. Teachers identified intervention characteristics (e.g., design quality, packaging, and program adaptability), student needs (e.g., trauma exposure, substances), and the fit between the intervention and the context as factors that contributed to acceptability. They also discussed the curriculum and its alignment with their teaching style and/or experiences as contributing to fidelity. Teachers shared how they would often go “off protocol” to improve intervention-context fit and meet students’ needs. Our results identified acceptability, a perceptual implementation outcome, as demonstrating an important role in shaping the relationship between CFIR factors and fidelity. Results provide guidance for systematically designing implementation strategies that address key barriers to improve acceptability, enhance fidelity, and ultimately achieve desired public health objectives.

Tobacco Prevention Using Social Skills Education and Puppet Scripts in an After-School Program

The purpose of this study was to explore the feasibility of implementing a tobacco use prevention intervention using social skills education and puppet scripts in an afterschool program. A total of 75 K-2 students attending an afterschool program in a rural Midwest area participated in a 4-lesson youth development tobacco prevention curriculum and completed a pre-post tobacco knowledge quiz. Additionally, 10 program mentors completed a pre-post program strengths and difficulties (SDQ) questionnaire on their assigned students. A series of t-tests were computed to examine differences in the pre and post scores of participants on the SDQ subscales, and total scales and descriptive statistics were computed on the tobacco knowledge quiz. Statistically significant differences were noted on 4 pre–post subscales scores of the SDQ and the total SDQ. Use of youth development curriculum using interactive puppet-based strategies implemented in afterschool settings may be a feasible health education strategy.

Evaluation and Impact of ASPIRE: An Interactive Tobacco Prevention Curriculum, among University Students in India

Online education approach provides innovative opportunities for engaging youths. Web-based, multimedia smoking prevention programs have been tested in high-income countries; however, efficacy of such programs is not well-investigated in low- and middle-income countries. The aim of this study was to evaluate the impact of A Smoking Prevention Interactive Experience (ASPIRE), an interactive tobacco prevention curriculum, among university students in India.A single-subject cohort study where each subject serves as their own control was conducted among university student participants engaged in ASPIRE, 60 minutes per week for five consecutive weeks during July to August of 2019. Assessments were conducted at baseline and immediately after exposure to ASPIRE. To evaluate the program, a structured instrument was specifically designed to measure the outcomes.A total of 103 university students participated voluntarily. Average age of the participants was 18.3±0.9 ranging from 17 to 20 years. Eighteen percent of students were curious to know about the various smoking products. More males were more susceptible to cigarette smoking as compared to females. The majority of participants felt that ASPIRE was culturally appropriate for young adults in India, but a modified version targeted toward Indian youth would be more acceptable. Pre- to postintervention knowledge of tobacco-related hazards increased from 70 to 97% (p < 0.001).ASPIRE, a multimedia interactive program, demonstrated its considerable potential to discourage smoking initiation among Indian youth.

Non-Pharmaceutical Interventions for Self-Regulatory Failures in Adolescents Suffering from Externalizing Symptoms: A Scoping Review

Introduction: Deficits of self-regulation (SR) are a hallmark of externalizing (EXT: offending or aggressive behaviors) symptoms in adolescence. Objectives: This scoping review aims (1) to map non-pharmaceutical interventions targeting SR processes to reduce EXT symptoms in adolescents and (2) to identify research gaps, both of which will provide recommendations for future studies. Methods: Systematic searches were carried out in eight bibliographic databases up to March 2021, combining the following concepts: self-regulation, externalizing symptoms, adolescents, and non-pharmaceutical interventions. Results: We identified 239 studies, including 24,180 youths, mainly from North America, which described a plethora of non-pharmaceutical interventions targeting SR to alleviate EXT symptoms in adolescents (10–18 years of age). The majority of studies (about 70%, k = 162) represent samples with interventions exposed to “selective” or “indicated” prevention. Curriculum-based (i.e., multiple approaches targeting several domains such as emotion, cognition, and social) interventions (31.4%) were the most common type of intervention. Moreover, studies on cognitive-based interventions, mind-based interventions, and emotional-based interventions have increased over the last decades. Network analyses allowed us to identify several hubs between curriculum-based interventions, cognitive SR processes, as well as aggressiveness, conduct problems, and irritability/anger dysregulation. In addition, we identified gaps of studies concerning the physiological SR processes and on some types of interventions (i.e., body-based interventions and externally mediated interventions) or, more specifically, on promising tools, such as biofeedback, neurofeedback, as well as programs targeting neuropsychological processes (e.g., cognitive remediation). Conclusions: This scoping review stresses the plethora of interventions, identified hubs, and emerging fields, as well as some gaps in the literature, which together may orient future studies.

Addressing the Opioid Epidemic with a K-12 Drug Prevention Curriculum, Website and Toolkit

Opioid overdose has become a large public health crisis with devastating consequences, particularly for young people. Programs have started to address the impact of prevention and education in approaching the issue, but many lack focus on helping students prevent drug misuse by practicing the skills students need to avoid or reduce risky health behaviors. The purpose of this manuscript is to introduce readers to the process of developing skills-based K - 12 Opioid/Rx Use educational lessons. Procedures: The educational lessons were developed using data-driven practice for the following age level clusters; K-2, 3-5, 6-8, and 9-12. All lessons contain active learning strategies and include a resource bank such that any teacher, administrator, or school personnel can select and deliver a lesson using the online interface.

Assessing the Effects of Childhelp’s Speak Up be Safe Child Abuse Prevention Curriculum for High School Students

Purpose This study examined the Childhelp Speak Up Be Safe (CHSUBS) child abuse prevention curriculum for high school students and addressed a gap in evidence-based child maltreatment prevention programs. CHSUBS is grounded in theory and was developed to 1) provide students with the skills they need to prevent or interrupt child abuse, bullying, and neglect, and 2) increase student knowledge about safety related to abuse. Methods Utilizing a cluster-randomized controlled trial design, the three high schools were randomly assigned to participate in the CHSUBS curriculum or the control group. Survey items measured the efficacy of the curriculum in grades 9 through 12. Surveys were implemented at baseline, immediately after the intervention, and after 6 months for a follow-up. Analyses included exploratory factor analyses and a paired samples t–test to determine whether increases in child maltreatment knowledge and resistance skills were gained. Results Findings showed positive significant results that child maltreatment knowledge and resistance skills were significantly different from pre to post for the CHSUBS group and showed no significant control group changes. Conclusions High school students in the CHSUBS group appeared to gain both child maltreatment knowledge and resistance skills. Future studies on prevention programming for high school students might show results that lead to a reduction in child maltreatment and an increase in better health outcomes for adolescents.