Improving the Reproductive Health of Families

改善家庭的生殖健康

• 批准号: 10431840
• 负责人: JANET S ST LAWRENCE
• 金额: $ 45.83万
• 依托单位: PORTLAND STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-28 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10431840
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent Risk Behavior; Adolescent sexual risk; Africa South of the Sahara; Age; Attitude; Award; Behavior; Behavior Therapy; Behavioral; Biological; Biological Markers; Botswana; Child; Child Rearing; Chlamydia; Cognitive; Communication; Communities; Comparison arm; Contraceptive methods; Cost Analysis; Data; Developing Countries; Education; Effectiveness; Effectiveness of Interventions; Face; Family; Family health status; Feasibility Studies; Feedback; Female Adolescents; Future; Gender; Gonorrhea; HIV; Health; Healthcare; Human Herpesvirus 2; Incidence; Informed Consent; Intervention; Interview; Knowledge; Measures; Mediating; Modeling; National Institute of Mental Health; Outcome; Parent-Child Relations; Parents; Participant; Play; Positive Reinforcements; Practice Management; Pregnancy Rate; Pregnancy in Adolescence; Prevalence; Psychometrics; Public Health; Randomized Controlled Trials; Reproductive Health; Risk; Role; Safety; Schools; Self Efficacy; Sex Behavior; Sex Education; Sexual Development; Sexually Transmitted Diseases; Strategic Planning; Student Dropouts; Teenagers; Testing; Time; Violence; Youth; acceptability and feasibility; adolescent health outcomes; arm; condoms; conflict resolution; cost effectiveness; delay sexual debut; design; evidence base; feasibility trial; follow-up; gender disparity; girls; improved; income disparities; informant; intergenerational; intervention delivery; intimate partner violence; longitudinal analysis; male; parental monitoring; peri-urban; pilot test; pilot trial; post intervention; prevent; programs; psychosocial; recruit; reproductive health intervention; reproductive health of adolescents; satisfaction; sex; sexual debut; sexual predators; sexual risk behavior; skills; social; social disparities; substance use; therapy design; treatment arm; urban area

Adolescents in Botswana face extraordinary reproductive health challenges. Teen pregnancy forces girls to leave school after which few resume their education. Botswana has the second highest HIV prevalence in the world, with incidence increasing rapidly at ages 15-19, peaking at 40.2% prevalence by ages 30-34. STIs are prevalent despite the availability of free health care. Traditional sex education, provided in now banned village initiation schools, is no longer available and parents are uncomfortable discussing reproductive health within the family. In an earlier R34 award, guided by a Community Advisory Board and Adolescent Advisory Group, we conducted formative interviews, assessed the psychometric adequacy of the proposed measures, and adapted and assessed the feasibility and acceptability of interventions for youth and their parents. We now propose to conduct a 3-arm randomized controlled trial with 500 families, ½ with a male and ½ with a female adolescent age 13-18. Arm 1 (N = 200) will receive the parent intervention “Families Matter 2!” (FM2!) and their adolescent will participate in “Living as a Safer Teen” (LAST). In Arm 2 (N = 200), parents receive FM2! Only and six months later their adolescents will receive LAST allowing us to assess the impact of the parent program alone and potential boost in outcomes when adolescents are also engaged in intervention. Arm 3 (N = 100), the comparison arm, will be the current, widely-delivered program in Botswana. Each adolescent and parent dyad will complete ACASI assessments in English or Setswana at baseline, post-intervention, 6- and 12-month follow-ups on family communication, parenting practices, knowledge of sexual development, and sexual behavior. Youth will also complete psychosocial measures assessing attitudes toward condoms, perceived barriers to sexual safety, attitudes toward transactional sex, acceptance of gender violence, and self-efficacy. Gonorrhea, chlamydia, herpes simplex virus type 2 (HSV2), and human immunodeficiency virus (HIV) will be tested at baseline and 12-month follow-up for adolescents. A pilot trial affirmed the feasibility of recruiting parent(caretaker)/adolescent dyads and retention exceeded 95% for both parents and adolescents. While the pilot trial was underpowered, results suggest that the interventions improved family communication, child management skills, knowledge of sexual development, attitudes toward contraception; lowered tolerance for intergenerational transactional sex and gender violence; and lowered sexual risk behavior of both parents and adolescents in the intervention arm. In addition, youths who were abstinent upon entering the pilot intervention appear to have delayed sexual debut more successfully than the comparison arm. This study addresses the highest priority in Botswana’s current national strategic plan. If the results provide strong evidence of effectiveness, the Ministries of Education, Health, Youth & Culture, National AIDS Coordinating Agency, and the Office of the President have committed to its dissemination throughout Botswana.

博茨瓦纳的青少年面临着巨大的生殖健康挑战。少女怀孕迫使女孩离开 学校毕业后，很少有人继续接受教育。博茨瓦纳是世界上艾滋病毒感染率第二高的国家， 发病率在15-19岁迅速增加，到30-34岁达到高峰，患病率为40.2%。性传播感染普遍存在， 提供免费保健。传统的性教育，在现在被禁止的乡村启蒙学校提供， 可用时间更长，父母在家庭内讨论生殖健康感到不舒服。在早期的R34中， 在社区咨询委员会和青少年咨询小组的指导下，我们进行了形成性访谈， 评估了拟议措施的心理测量充分性，并调整和评估了可行性， 对青年及其父母干预的可接受性。我们现在建议进行一项3组随机对照研究， 在500个家庭中进行了一项试验，其中一半是男性，一半是13-18岁的女性青少年。第1组（N = 200）将接受 家长干预“家庭问题2！”(FM2!)他们的青少年将参加“更安全的青少年生活” （最后）。在组2（N = 200）中，父母接受FM 2！六个月后，他们的青少年将接受LAST 这使我们能够评估单独的父母计划的影响，以及当青少年也 参与干预。第3组（N = 100）是比较组，将是目前广泛交付的项目， 波札那.每个青少年和父母二人组将在基线时用英语或西班牙语完成ACASI评估， 干预后，6个月和12个月的随访，包括家庭沟通、养育方式、性知识、 发展和性行为。青少年还将完成心理社会措施， 安全套、性安全的感知障碍、对性交易的态度、对性别暴力的接受程度，以及 自我效能淋病、衣原体、单纯疱疹病毒2型（HSV 2）和人类免疫缺陷病毒（HIV） 将在青少年的基线和12个月随访时进行测试。一项试点试验肯定了招募的可行性 父母（照顾者）/青少年的二人组和保留超过95%的父母和青少年。虽然试点试验 是动力不足，结果表明，干预措施改善了家庭沟通，儿童管理技能， 性发育知识，对避孕的态度;对代际交易的容忍度降低 性暴力和性别暴力;以及干预组中父母和青少年的性风险行为降低。 此外，在进入试点干预后禁欲的年轻人似乎推迟了首次性行为， 这项研究解决了博茨瓦纳目前国家战略中的最高优先事项， 计划如果结果提供了有效性的有力证据，教育部、卫生部、青年和文化部， 国家艾滋病协调机构和总统办公室已承诺在全国各地传播该文件， 波札那.

项目成果

Batswana Adolescents' Attitudes Toward Sex With Older Adults: Psychometric Properties of the Attitudes Toward Transactional Sex Scale.

博茨瓦纳青少年对与老年人发生性行为的态度：对交易性行为态度量表的心理测量特性。

• DOI: 10.1177/10731911221146518
• 发表时间: 2023
• 期刊: Assessment
• 影响因子: 3.8
• 作者: StLawrence,JanetS;Sun,ChristinaJ;Seloilwe,EstherS;Magowe,MabelKM;Rampa,Shathani;Dithole,KefalotseS
• 通讯作者: Dithole,KefalotseS