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Abstract #151017

Scott Rhodes, PhD, MPH, CHES¹, Kimberly Wagoner¹, Thomas McCoy, MS², Ashley Wagoner³, Leslie Tuttle⁴, and Mark Wolfson¹. (1) Div of Public Health Sciences/Dept of Social Sciences & Health Policy, Wake Forest University School of Medicine, 2000 W. 1st Street, Winston-Salem, NC 27157-1063, 336-713-5080, srhodes@wfubmc.edu, (2) Department of Biostatistical Science, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, (3) Division of Public Health Sciences/Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, 2000 W. First St., Winston-Salem, NC 27104, (4) Social Sciences and Health Policy, Wake Forest University School of Medicine, Public Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1063

Background: Because fidelity to the intervention model may vary across schools, we documented delivery and coverage of the intervention.

Methods: The Environmental Strategy Implementation Survey (ESIS) collected data from the “point-people” at each of the 10 schools. The ESIS documented inputs and processes implementing environmental strategies through community organizing, and generated a site-level “dose” measure in the secondary outcome analysis. Data were masked and 5 expert Reviewers rated each school based on how closely they adhered to the community-organizing model. The Shrout-Fleiss inter-rater reliability was 0.97 for the 5 raters. The resulting measures of “Inputs” into and “Process” of community organizing were used as site-level “dose” measures in secondary analyses of outcome data. These measures were tested for 3-way interactions with group and time for each of the main outcomes.

Results: The intervention schools were consistently stronger than the 5 comparison schools in both Inputs and Process, illustrating varying but increased fidelity to the community-organizing model. Higher levels of fidelity to the model were associated with: decreased number of days drunk in past week (p=0.01) and number of days students drank in past 30 days (p=0.04); reduced dorm-level consequences of drinking (p<0.02); reduced dorm-level high-risk drinking environment (p<0.03); and reduced dorm-level high-risk drinking activities (p<0.01).

Conclusions: Our findings indicate that higher levels of fidelity to the model were associated with reductions in high-risk drinking and its consequences. The ESIS may serve as a guide for researchers and practitioners to develop more precise ways to measure program implementation and dose response.

Learning Objectives:

• Describe an innovative approach to process evaluation;
• Outline the implementation of the process evaluation; and
• Interpret the outcomes of a community-organizing intervention based on the incorporation of the process evaluation

Keywords: Evaluation, Community Collaboration

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.