Psychosocial prevention research lacks evidence from intensive within-person lines of research to understand idiographic processes related to development and response to intervention. Such data could be used to fill gaps in the literature and expand the study design options for prevention researchers, including lower-cost yet rigorous studies (e.g., for program evaluations), pilot studies, designs to test programs for low prevalence outcomes, selective/indicated/ adaptive intervention research, and understanding of differential response to programs. This study compared three competing analytic strategies designed for this type of research: autoregressive moving average, mixed model trajectory analysis, and P-technique. Illustrative time series data were from a pilot study of an intervention for nursing home residents with diabetes (N=4) designed to improve control of blood glucose. A within-person, intermittent baseline design was used. Intervention effects were detected using each strategy for the aggregated sample and for individual patients. The P-technique model most closely replicated observed glucose levels. ARIMA and P-technique models were most similar in terms of estimated intervention effects and modeled glucose levels. However, ARIMA and P-technique also were more sensitive to missing data, outliers and number of observations. Statistical testing suggested that results generalize both to other persons as well as to idiographic, longitudinal processes. This study demonstrated the potential contributions of idiographic research in prevention science as well as the need for simulation studies to delineate the research circumstances when each analytic approach is optimal for deriving the correct parameter estimates.
Despite advances in prevention science and practice in recent decades, the U.S. continues to struggle with significant alcohol-related risks and consequences among youth, especially among vulnerable rural and Native American youth. The Prevention Trial in the Cherokee Nation is a partnership between prevention scientists and Cherokee Nation Behavioral Health to create, implement, and evaluate a new, integrated community-level intervention designed to prevent underage drinking and associated negative consequences among Native American and other youth living in rural high-risk underserved communities. The intervention builds directly on results of multiple previous trials of two conceptually distinct approaches. The first is an updated version of CMCA, an established community environmental change intervention, and the second is CONNECT, our newly developed population-wide intervention based on screening, brief intervention, and referral to treatment (SBIRT) research. CMCA direct-action community organizing is used to engage local citizens to address community norms and practices related to alcohol use and commercial and social access to alcohol among adolescents. The new CONNECT intervention expands traditional SBIRT to be implemented universally within schools. Six key research design elements optimize causal inference and experimental evaluation of intervention effects, including a controlled interrupted time-series design, purposive selection of towns, random assignment to study condition, nested cohorts as well as repeated cross-sectional observations, a factorial design crossing two conceptually distinct interventions, and multiple comparison groups. The purpose of this paper is to describe the strong partnership between prevention scientists and behavioral health leaders within the Cherokee Nation, and the intervention and research design of this new community trial.
American Indians (AIs) suffer from signifi cant alcohol-related health disparities, and increased risk begins early. This study examined the reliability and validity of measures to be used in a preventive intervention trial. Reliability and validity across racial/ethnic subgroups are crucial to evaluate intervention effectiveness and promote culturally appropriate evidence-based practice. Method: To assess reliability and validity, we used three baseline surveys of high school students participating in a preventive intervention trial within the jurisdictional service area of the Cherokee Nation in northeastern Oklahoma. The 15-minute alcohol risk survey included 16 multi-item scales and one composite score measuring key proximal, primary, and moderating variables. Forty-four percent of the students indicated that they were AI (of whom 82% were Cherokee), including 23% who reported being AI only (n = 435) and 18% both AI and White (n = 352). Forty-seven percent reported being White only (n = 901). Results: Scales were adequately reliable for the full sample and across race/ethnicity defi ned by AI, AI/ White, and White subgroups. Among the full sample, all scales had acceptable internal consistency, with minor variation across race/ethnicity. All scales had extensive to exemplary test-retest reliability and showed minimal variation across race/ethnicity. The eight proximal and two primary outcome scales were each signifi cantly associated with the frequency of alcohol use during the past month in both the cross-sectional and the longitudinal models, providing support for both criterion validity and predictive validity. For most scales, interpretation of the strength of association and statistical signifi cance did not differ between the racial/ ethnic subgroups. Conclusions: The results support the reliability and validity of scales of a brief questionnaire measuring risk and protective factors for alcohol use among AI adolescents, primarily members of the Cherokee Nation.
ABSTRACT. Objective: American Indians (AIs) suffer from signifi cant alcohol-related health disparities, and increased risk begins early. This study examined the reliability and validity of measures to be used in a preventive intervention trial. Reliability and validity across racial/ethnic subgroups are crucial to evaluate intervention effectiveness and promote culturally appropriate evidence-based practice. Method: To assess reliability and validity, we used three baseline surveys of high school students participating in a preventive intervention trial within the jurisdictional service area of the Cherokee Nation in northeastern Oklahoma. The 15-minute alcohol risk survey included 16 multi-item scales and one composite score measuring key proximal, primary, and moderating variables. Forty-four percent of the students indicated that they were AI (of whom 82% were Cherokee), including 23% who reported being AI only (n = 435) and 18% both AI and White (n = 352). Forty-seven percent reported being White only (n = 901). Results: Scales were adequately reliable for the full sample and across race/ethnicity defi ned by AI, AI/ White, and White subgroups. Among the full sample, all scales had acceptable internal consistency, with minor variation across race/ethnicity. All scales had extensive to exemplary test-retest reliability and showed minimal variation across race/ethnicity. The eight proximal and two primary outcome scales were each signifi cantly associated with the frequency of alcohol use during the past month in both the cross-sectional and the longitudinal models, providing support for both criterion validity and predictive validity. For most scales, interpretation of the strength of association and statistical signifi cance did not differ between the racial/ ethnic subgroups. Conclusions: The results support the reliability and validity of scales of a brief questionnaire measuring risk and protective factors for alcohol use among AI adolescents, primarily members of the
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.