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

申请人寻求这个K99/R 00奖，以实现干预科学的研究独立性， 注重改善情绪调节，减少物质使用、暴力行为和性冒险 脆弱的年轻人。青少年罪犯（JO）-谁是不成比例的非洲裔美国人-在高 艾滋病毒/性传播感染的风险，部分原因是 三个相互关联的领域由不良的情绪调节所支撑：物质使用、暴力行为和性行为。 冒险基于正念的干预（MBIs）可以改善情绪调节，从而减少 艾滋病毒/性传播感染风险。然而，在司法工作者中，精神障碍指数对物质使用、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到社区， 逮捕，通常没有基于证据的干预服务，定位他们正在进行的风险行为。给定 由于青少年司法系统资源有限，应用程序提供的移动的干预是一种很有前途的方法， 如何接触这些年轻人这一点是强调的事实，非洲裔美国青年是 最有可能拥有并经常使用智能手机的种族/族裔群体。因此，申请人建议调整一个 现有的应用程序包括基于证据的MBI方法，以专门解决艾滋病毒/性传播感染风险行为 在13-17岁试用期（K99阶段）的男女初级司法人员中， app（K99阶段），然后对其功效进行严格的测试（R 00阶段）。在K99阶段，她将 与现有MBI应用程序的制造商合作，根据焦点对其平台进行编程修改 小组反馈（n = 3组，每组n = 5-8个JO），然后解决确定的任何必要的改进 在α测试期间（n = 10个JO）。在R 00阶段，JO将被随机分配到经过调整的MBI app（n = 100）或同等强度的健康促进对照app（n = 100）。在这两种情况下，青年将 每天提示完成10分钟的指导性干预活动，持续30天。情绪调节， 物质使用、暴力行为和性风险行为将在基线、干预后和六个月进行评估。 个月协调的培训计划将使申请人建立在她的情感基础上 在脆弱的青年中进行监管和冒险，在对她的独立至关重要的三个领域发展新技能： (1)针对高危青少年的干预措施的调整和设计，（2）移动的干预措施的提供，以及（3）有效性 试验.在K99阶段，她的导师团队将利用其在指导初级学生方面的持续记录， 学者完全独立。这将通过定期会议，指导阅读，手- 辅导，并支持她在研讨会，课程和会议上的活动。完成R 00阶段 将生成数据，以支持未来的R 01应用程序，以测试适应的 在更大的范围内。因此，K99/R 00奖将为申请人提供一个平台， 在干预科学的独立职业生涯，重点是情绪和易受伤害的青少年的危险行为。

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.