Data_Sheet_1_Development and implementation of the ECHO model in a school setting to address youth electronic cigarette use in Kansas: A protocol.pdf

IntroductionSchools remain at the frontlines of addressing issues, such as e-cigarette use, that impact students. Despite e-cigarette use remaining a significant public health concern in the U.S., schools have limited resources (e.g., staff, capacity, programming) to address it, especially in rural and frontier areas. This ECHO Pilot Project aimed to build capacity and equip schools and school staff in the state of Kansas to address high rates of youth e-cigarette use by providing prevention support and information on best practices for e-cigarette cessation.
Methods and analysisThe pilot used the established Project ECHO model to disseminate evidence-based strategies for e-cigarette prevention and cessation among youth to schools across Kansas. The pilot selected 20 interdisciplinary school teams representing both rural and urban middle and high schools across the state to participate in seven ECHO sessions. ECHO sessions proceeded throughout Fall 2021, with the final session in Spring 2022. School participants completed pre-post surveys as well as component-specific surveys following each ECHO session. In addition, each school team created an individualized action plan to comprehensively address e-cigarette use at their school based on the information provided throughout the ECHO. Survey data, school tobacco/nicotine policies, and action plans will be analyzed to assess process and final outcomes.
DiscussionIf successful, this pilot will demonstrate that the ECHO model is an effective platform for building school staff knowledge and skills to implement evidence-based strategies in both urban and rural settings. It is anticipated that the pilot will build capacity and equip schools and school staff to address high rates of youth e-cigarette use by providing support for school-based prevention programs and referrals for e-cigarette cessation which will lessen the burden of nicotine-related problems in Kansas schools and communities. Finally, the pilot will provide evidence that the ECHO model can be successfully and equitably applied in a school setting and may be a viable method for addressing other public health-related issues faced by schools.

引言
学校始终处于解决影响学生的各类问题（如电子烟使用问题）的第一线。尽管电子烟使用仍是美国面临的重大公共健康关切，但学校可用于应对该问题的资源（如教职人员、实施能力、项目资源）十分有限，在乡村与边远地区尤为如此。本ECHO试点项目（Project ECHO）旨在通过提供电子烟预防支持及戒断最佳实践相关信息，提升堪萨斯州各学校及教职员工的能力，以应对该州青少年电子烟使用率居高不下的问题。

方法与分析
本试点采用成熟的Project ECHO模式，向堪萨斯州各学校推广针对青少年电子烟预防与戒断的循证策略。本次试点遴选了20支跨学科学校团队，涵盖全州城乡初高中学校，参与共7次ECHO研讨会。研讨会于2021年秋季至2022年春季期间开展，末次研讨会于2022年春季举行。参与的学校团队需完成前后测问卷，并在每次ECHO研讨会后完成分项专项问卷。此外，各学校团队需根据ECHO项目全程提供的信息，制定一份个性化行动计划，以全面解决本校的电子烟使用问题。研究将对问卷数据、学校烟草/尼古丁政策及行动计划进行分析，以评估项目过程与最终成效。

讨论
若本试点取得成功，将证明ECHO模式是能够有效提升教职员工知识与技能的平台，使其可在城乡环境中落地实施循证策略。预期本试点将通过支持校内预防项目及提供电子烟戒断转介服务，提升学校及教职员工的能力，从而减轻堪萨斯州各学校与社区中尼古丁相关健康问题的负担。此外，本试点将提供证据，证明ECHO模式可在学校场景中成功且公平地应用，或可成为解决学校面临的其他公共健康相关问题的可行方案。