Reducing HIV/Sexually Transmitted Infection (STI) Risk Behaviors among Juvenile Offenders on Probation: A Mobile Mindfulness-Based Intervention

申请者寻求K99/R00奖，以实现干预科学研究的独立性，并获得 重点改善情绪调节，减少药物使用、暴力行为和性风险 在易受伤害的青年中。少年犯(JO)--他们中不成比例的是非裔美国人--处于兴奋状态 人类免疫缺陷病毒(HIV)/性传播感染(STI)的风险，部分原因是 情绪调节不良的三个相互关联的领域：物质使用、暴力行为和性行为 敢于冒险。基于正念的干预(MBIS)可以改善情绪调节，因此可能会减少 艾滋病毒/性传播感染风险。然而，MBIS对JOS人群的药物使用、暴力和性风险的影响是 未知。重要的是，近80%的青少年在缓刑后被释放回社区 逮捕，通常没有基于证据的干预服务，为他们持续的危险行为做好准备。vt.给出 在少年司法系统有限的资源下，APP提供的移动干预是一个有希望的 接触这些年轻人的方法。这一点被以下事实所突显：非裔美国青年是 最有可能拥有并经常使用智能手机的种族/民族。因此，申请人建议修改一项 现有的APP包含基于证据的MBI方法，以专门处理艾滋病毒/性传播感染的危险行为 在13-17岁试用期(K99阶段)的男性和女性JOS中，进行适应 APP(K99阶段)，然后运行其功效的严格测试(R00阶段)。在K99阶段，她将 与现有MBI应用程序的开发者协作，根据Focus对其平台进行编程修改 小组反馈(n=3组，n=5-8 JOS/组)，然后处理确定的任何必要的改进 在阿尔法试验期间(n=10 JOS)。在R00阶段，JOS将被随机分配到适配的MBI APP(n=100)或同等强度的健康促进控制APP(n=100)。在这两种情况下，年轻人都会 提示每天完成10分钟的指导性干预活动，持续30天。情绪调节， 药物使用、暴力行为和性行为风险将在基线、干预后和6个月进行评估 月份。协调的培训计划将使申请者在情感上建立坚实的基础 对弱势青年的监管和冒险，在对她独立至关重要的三个领域培养新技能： (1)适应和设计针对高危青年的干预措施，(2)流动干预提供，和(3)有效性 测试。在K99阶段，她的指导团队将利用其在指导少年方面的持续记录 学者们要完全独立。这将通过定期会议、定向阅读、动手- 关于教程，以及对她在研讨会、课程和会议中的活动的支持。完成R00阶段 将生成数据以支持未来的R01应用程序，以测试适配的 更大规模的MBI。因此，K99/R00奖项将为申请者提供一个平台来启动她 独立从事干预科学研究，重点关注弱势青年的情绪和危险行为。

The applicant seeks this K99/R00 award to achieve research independence in intervention science, with a focus on improving emotion regulation and reducing substance use, violent behavior, and sexual risk taking among vulnerable youth. Juvenile offenders (JOs)—who are disproportionately African American—are at high risk for human immunodeficiency virus (HIV)/sexually transmitted infections (STI) due in part to elevations in three interrelated areas underpinned by poor emotion regulation: substance use, violent behavior, and sexual risk taking. Mindfulness-based interventions (MBIs) improve emotion regulation and may thereby reduce HIV/STI risk. However, the effects of MBIs on substance use, violence, and sexual risk taking among JOs are unknown. Importantly, nearly 80% of juveniles are released back into the community on probation following arrest, typically without evidence-based intervention services, positioning them for ongoing risk behavior. Given limited resources within the juvenile justice system, mobile interventions delivered by app are a promising method of reaching these youth. This point is underscored by the fact that African American youth are the racial/ethnic group most likely to own and regularly use smartphones. The applicant thus proposes to adapt an existing app comprised of evidence-based MBI methods in order to specifically address HIV/STI risk behaviors among male and female JOs 13-17 years old on probation (K99 phase), conduct an alpha test of the adapted app (K99 phase), and then run a rigorous test of its efficacy (R00 phase). During the K99 phase, she will collaborate with the makers of the existing MBI app to program modifications to their platform based on focus group feedback (n = 3 groups with n = 5-8 JOs/group), and then address any necessary refinements identified during alpha testing (n = 10 JOs). During the R00 phase, JOs will be randomly assigned to the adapted MBI app (n = 100) or an equally intensive health promotion control app (n = 100). In both conditions, youth will be prompted to complete 10 minutes of guided intervention activity daily for 30 days. Emotion regulation, substance use, violent behavior, and sexual risk taking will be assessed at baseline, post intervention, and six months. The coordinated training plan will allow the applicant to build on her strong foundation in emotion regulation and risk taking in vulnerable youth, developing new skills in three areas critical to her independence: (1) adaptation and design of interventions for high-risk youth, (2) mobile intervention delivery, and (3) efficacy testing. During the K99 Phase, her mentorship team will draw on its sustained track record in mentoring junior scholars to full independence. This will be accomplished through regular meetings, directed readings, hands- on tutorials, and support of her activity in workshops, courses, and conferences. Completion of the R00 phase will generate data to support a future R01 application to test effectiveness and implementation of the adapted MBI on a larger scale. The K99/R00 award will thus provide the applicant with a platform to launch her independent career in intervention science with a focus on emotion and risk behavior in vulnerable youth.