Comparison of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection: Results of a randomized controlled trial
Comparison of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection: Results of a randomized controlled trial
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DOI：
10.1016/j.ijnurstu.2011.08.010
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发表时间：
2012-02-01
影响因子：
8.1
通讯作者：
Collins, Jennifer L.
中科院分区：
文献类型：
--
作者：
Champion, Jane Dimmitt;Collins, Jennifer L.
背景资料：有性虐待或身体虐待和性传播感染史的少数民族少女是易感染艾滋病毒的弱势群体。以社区为基础的行为矫正和随后的风险降低干预措施在这些妇女中并不有效。（艾滋病风险降低模型）认知行为干预模型与加强咨询受虐待的少数民族青少年妇女感染性传播感染在6个月和12个月的后续行动。设计：纵向随访的对照随机试验。设置：美国西南部，大都会社区诊所。参与者：14-18岁的墨西哥和非洲裔美国青少年女性，有虐待或性传播感染史，寻求性健康护理。方法：进行了广泛的干预措施开发的初步研究，包括个人访谈，焦点小组，二次数据分析，预测试和可行性测试，在随机对照试验测试之前，对基于证据的干预措施进行修改。在知情同意参与试验后，获得了关于人口统计学、滥用史、性风险行为、性健康和体格检查的详细访谈。随机分为对照组和干预组。干预参与者接受了工作坊，支持小组和个人辅导课程。对照组参与者接受了虐待和加强临床咨询。在研究入组后6个月和12个月进行随访，包括详细访谈和体格检查，以评估感染情况。意向治疗分析进行了评估干预效果卡方和多元回归models.Results：409墨西哥（n = 342）和非洲（n = 67）美国青少年妇女的虐待和性传播感染的历史入组; 90%的干预组出席;纵向随访6（93%）和12（94%）个月。干预组（n = 199）与对照组（n = 210）相比，在0-6岁时感染较少（0%与6.6%，p = .001），6-12（3.6% vs 7.8%，p = 0.005，CI 95%下限-上限0.001 - 0.386）和0-12（4.8%对13.2%，p = .002，CI 95%下限-上限，.002-.531）个月间隔。认知行为干预，专门为少数民族青少年妇女的虐待和性传播感染的历史是有效的预防感染。这些结果为制定性传播感染/艾滋病毒的循证干预措施提供了证据。所涉问题包括转化为社区诊所为基础的设置，以防止对青春期妇女的性健康的不良后果。(C)2011爱思唯尔有限公司版权所有。
Background: Ethnic minority adolescent women with a history of sexual or physical abuse and sexually transmitted infections represent a vulnerable population at risk for HIV. Community-based interventions for behavior modification and subsequent risk reduction have not been effective among these women.Objectives: To evaluate the effects of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention model versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection at 6 and 12 months follow-up.Design: Controlled randomized trial with longitudinal follow-up.Settings: Southwestern United States, Metropolitan community-based clinic.Participants: Mexican-and-African American adolescent women aged 14-18 years with a history of abuse or sexually transmitted infection seeking sexual health care.Methods: Extensive preliminary study for intervention development was conducted including individual interviews, focus groups, secondary data analysis, pre-testing and feasibility testing for modification of an evidence-based intervention prior to testing in the randomized controlled trial. Following informed consents for participation in the trial, detailed interviews concerning demographics, abuse history, sexual risk behavior, sexual health and physical exams were obtained. Randomization into either control or intervention groups was conducted. Intervention participants received workshop, support group and individual counseling sessions. Control participants received abuse and enhanced clinical counseling. Follow-up including detailed interview and physical exam was conducted at 6 and 12 months following study entry to assess for infection. Intention to treat analysis was conducted to assess intervention effects using chi-square and multiple regression models.Results: 409 Mexican-(n = 342) and African-(n = 67) American adolescent women with abuse and sexually transmitted infection histories were enrolled; 90% intervention group attendance; longitudinal follow-up at 6(93%) and 12(94%) months. Intervention (n = 199) versus control (n = 210) group participants experienced fewer infections at 0-6(0% versus 6.6%, p = .001), 6-12 (3.6% versus 7.8%, p = .005, CI 95% lower-upper .001-.386) and 0-12 (4.8% versus 13.2%, p = .002, CI 95% lower-upper, .002-.531) month intervals.Conclusions: A cognitive behavioral intervention specifically designed for ethnic minority adolescent women with a history of abuse and sexually transmitted infection was effective for prevention of infection. These results provide evidence for development of evidence-based interventions for sexually transmitted infection/HIV. Implications include translation to community-clinic-based settings for prevention of adverse outcomes regarding sexual health of adolescent women. (C) 2011 Elsevier Ltd. All rights reserved.