Protecting our future generation: study protocol for a randomized controlled trial evaluating a sexual health self-care intervention with Native American youth and young adults
Protecting our future generation: study protocol for a randomized controlled trial evaluating a sexual health self-care intervention with Native American youth and young adults
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DOI：
10.1186/s12889-019-7956-x
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发表时间：
2019-12-02
影响因子：
4.5
通讯作者：
Charlotte, Gaydos
中科院分区：
文献类型：
--
作者：
Lauren, Tingey;Catherine, Sutcliffe;Charlotte, Gaydos
性传播感染（STI）的差异是美国土著青年和年轻人之间的一个紧迫问题，这并不能完全解释为不同的性行为或相关行为。这些性健康差异更可能归因于社会环境和结构性决定因素，如性保健提供者短缺，社会经济地位较低，以及获得性传播感染筛查和治疗的障碍，包括地理隔离和保密问题。促进性传播感染筛查和治疗的创新性、非诊所替代办法对于缩小这些差距至关重要。自我照顾，或个人对自己的健康和福祉的照顾可能是这样一种策略。这项研究将评估一项名为“保护我们的下一代”的自我护理干预措施的有效性，以增加对性传播感染筛查的接受，并影响居住在美国西南部保留地社区的美国土著青年和年轻人的性风险和保护行为。方法本研究为随机对照试验，旨在测试自我护理干预与对照条件相比的有效性。参与者将是14-26岁的美国原住民，他们一生中至少有一次阴道或肛交。参与者将随机接受干预，包括：1）性健康自我评估，嵌入式临床预测工具预测STI阳性，2）个性化消息传递，关键步骤降低STI风险，或控制条件，包括：1）关于水，苏打水和含糖饮料消费的自我评估，2）个性化消息传递，以满足推荐的每日摄入量。所有参与者都将接受自我管理的STI测试。参与者将在基线、3个月和6个月随访时完成评估。主要结果指标是完成性传播感染筛查。保护我们的下一代是第一个自我保健干预措施，专门关注美国土著人口的性健康，他们忍受着显著的性健康差异，在研究中代表性不足。如果有效，干预措施将成为美国土著青年和年轻人的性健康自我保健模式，适用于医疗保健和社区环境。
Background Disparities in sexually transmitted infections (STI) are an urgent problem among Native American youth and young adults which are not fully explained by different sexual or related behaviors. These sexual health disparities are more likely attributed to social environments and structural determinants such as a shortage of sexual healthcare providers, lower socioeconomic status, and access barriers to STI screening and treatment, including geographic isolation and confidentiality concerns. Innovative, non-clinic based alternatives to promote STI screening and treatment are essential for alleviating these disparities. Self-care, or the care taken by individuals towards their own health and well-being may be such a strategy. This study will assess the efficacy of a self-care intervention, called Protecting Our Future Generation, for increasing uptake of STI screening and impacting sexual risk and protective behaviors among Native American youth and young adults living in a reservation-based community in the Southwestern United States. Methods The proposed study is a randomized controlled trial to test the efficacy of a self-care intervention compared to a control condition. Participants will be Native Americans ages 14-26 years old who have had vaginal or anal sex at least once in their lifetime. Participants will be randomized to the intervention which includes: 1) a sexual health self-assessment with embedded clinical prediction tool predicting STI positivity, and 2) personalized messaging with key steps to lower risk for STIs, or the control condition which includes: 1) a self-assessment about water, soda and sugar sweetened beverage consumption, and 2) personalized messaging to meet recommended daily intake. All participants will be offered a self-administered STI test. Participants will complete assessments at baseline, 3- and 6-months follow-up. The primary outcome measure is completion of STI screening. Discussion Protecting Our Future Generation is among the first self-care interventions uniquely focused on sexual health among a Native American population, who endure significant sexual health disparities and are under-represented in research. If efficacious, the intervention will be a model of sexual health self-care for Native American youth and young adults adaptable for use in healthcare and community-based settings.