Implementing the teen marijuana check-up in schools-a study protocol

Area of Science:

• Implementation Science
• Adolescent Behavioral Health
• Substance Use Interventions

Background:

• Substance misuse, particularly marijuana use, is prevalent among adolescents.
• Schools are key points for accessing student behavioral health services.
• The Teen Marijuana Check-Up (TMCU) is an effective intervention for adolescent marijuana misuse.

Purpose of the Study:

• To test a novel, "as-needed" technical assistance strategy for implementing school-based TMCU.
• To compare this strategy against traditional, resource-intensive "gold-standard" technical assistance.
• To evaluate the cost-effectiveness and sustainability of school-based interventions for adolescent substance misuse.

Main Methods:

• A type II effectiveness-implementation hybrid trial using the EPIS framework.
• Randomized controlled trial comparing "as-needed" vs. "gold-standard" technical assistance for TMCU.
• Mixed-methods approach including interviews, training, outcome assessments, and cost analyses.

Main Results:

• Hypothesized non-differential influence of technical assistance methods on fidelity and effectiveness.
• Anticipated lower school costs for the "as-needed" technical assistance strategy.
• Expected greater reduction in marijuana use frequency for students receiving TMCU compared to waitlist control.

Conclusions:

• The "as-needed" technical assistance model shows promise for cost-effective implementation of school-based interventions.
• A "fidelity drift alarm" concept could be transferable to other health settings and interventions.
• This trial advances understanding of best practices for implementing efficacious, school-based adolescent substance misuse services.