Using a discrete choice experiment to determine preferences for STI testing models for Black adolescent males

使用离散选择实验来确定黑人青少年男性对性传播感染测试模型的偏好

• 批准号: 10528195
• 负责人: Melissa Kottke
• 金额: $ 26.18万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10528195
• 关键词: 19 year old; Adolescent; Adoption; Area; Behavior; Behavioral; Black Populations; Black race; COVID-19; Caring; Characteristics; Choice Behavior; Clinic; Clinical; Communities; Comprehension; Contracts; Data; Development; Ecosystem; Ectopic Pregnancy; Epidemic; Exercise; Experimental Designs; Female; Female infertility; Focus Groups; HIV; HIV Infections; Health; Health Services; Heterogeneity; Human immunodeficiency virus test; Infection; Infertility; Insurance; Intervention; Interview; Lead; Life; Location; Male Adolescents; Male Infertility; Methodology; Methods; Minority Groups; Modeling; National Institute of Child Health and Human Development; Nature; Outcome; Participant; Pelvic Inflammatory Disease; Personal Satisfaction; Population; Predisposition; Privatization; Process; Qualitative Methods; Research; Research Personnel; Respondent; Risk; Sampling; Self Administration; Series; Services; Sexual Health; Sexual Partners; Sexually Transmitted Diseases; Strategic Planning; Structure; Surveys; Systems Theory; Teenagers; Testing; Time; Variant; Vulnerable Populations; Youth; base; behavioral economics; black men; cognitive testing; cost; cost effectiveness; design; empowered; experience; experimental study; health disparity; high risk; home test; infection rate; infection risk; innovation; male; men; men who have sex with men; metropolitan; neglect; neonatal outcome; peer; preference; recruit; sexually active; testing services; transmission process; uptake; young adult; young man

PROJECT SUMMARY Of the 26 million new sexually transmitted infections (STI) in 2018, almost half were among adolescents (15-19 years old) and young adults (20-24 years old). Millions of cases remain undiagnosed and untreated, particularly among male teens. Less than 3% of sexually active male teens have had an STI test in the past 12 months versus 26% of their female peers. Male teens are more likely to forego testing than female teens due to greater confidentiality concerns, cost/insurance barriers, and lower self-perceived risk. COVID-19 has exacerbated barriers to STI care, as testing services have plummeted by 66% since March 2020. There is great urgency to develop innovative and effective methods to screen adolescent males for STIs: as males are largely asymptomatic, their untreated STIs can be transmitted unknowingly to other sexual partners. Untreated STIs can lead to male and female infertility and increase one’s susceptibility to contracting HIV. The objective of this R21 is to use an innovative, user-centered approach, a discrete choice experiment, to determine the preferences for STI testing models among Black adolescent males. In a discrete choice experiment (DCE), a methodology that has been widely used to inform the design/adoption of health services, respondents are presented with two services with different attributes and are asked to choose which one they prefer (e.g., Testing Model A or B). This series of choice-tasks elucidates the relative importance of certain attributes as well as acceptable trade- offs. Importantly, DCEs can be used to highlight shared but distinct preferences within different groups of Black adolescent males, which may justify the development of multiple, tailored STI testing models. The Early- Investigator-led team, with extensive expertise in recruiting Black youth, will accomplish this objective through two aims: Aim 1 will build the DCE collaboratively with a community-based Youth Advisory Board comprised of 15 Black male adolescents from Atlanta, GA. Qualitative methods such as interviews, focus groups, and pile- sort exercises will be used to define the testing attributes (e.g., test location, time till results) which are most important to youth; these attributes will be integrated into the experimental design of the DCE. Aim 2 will leverage multi-platform community-based and online strategies to recruit a heterogenous sample of 500 Black male adolescents to participate in a 15-minute online DCE. A latent class analysis will be used to elucidate preference heterogeneity for STI testing, explore groups or classes with distinct attribute preferences, and assess associated behaviors/characteristics. The research approach will be anchored in DCE best practices and in the Phenomenological Variant of Ecological Systems Theory, a framework that recognizes the unique contexts in which Black youth develop. This R21 innovatively explores a growing health disparity in a population often neglected in research. Aligning with the NICHD Strategic Plan, this study will engage Black adolescent males in STI services critical to support their own sexual health and their partners’. Future research will create and test the acceptability and cost-effectiveness of diverse STI testing models in increasing testing rates among youth.

项目总结 在2018年新增的2600万性传播感染(STI)病例中，近一半是青少年(15-19岁 和青壮年(20-24岁)。数百万病例仍未得到诊断和治疗，尤其是 在十几岁的男性中。在过去的12个月里，只有不到3%的性行为活跃的男性青少年接受过性传播感染检测 相比之下，她们的女性同龄人中有26%。男性青少年比女性青少年更有可能放弃测试，因为 保密问题、成本/保险障碍和较低的自我感知风险。新冠肺炎加剧了 STI护理的障碍，因为检测服务自2020年3月以来暴跌了66%。当务之急是 开发创新和有效的方法来筛查性传播感染的青春期男性：因为男性主要是 在没有症状的情况下，他们未经治疗的性传播疾病可能会在不知情的情况下传染给其他性伴侣。未经治疗的性传播感染可能 导致男性和女性不孕，增加感染艾滋病毒的易感性。R21的目标是 是使用一种创新的、以用户为中心的方法，即离散选择实验，来确定以下各项的偏好 黑人青春期男性的性传播感染测试模型。在离散选择实验(DCE)中，一种方法 已被广泛用于为设计/采用医疗服务提供信息，受访者收到了两份 具有不同属性的服务，并被要求选择他们更喜欢的服务(例如，测试模型A或B)。 这一系列的选择任务阐明了某些属性以及可接受的交易的相对重要性- 关了。重要的是，DCE可用于突出不同黑人组中共享但不同的首选项 青春期男性，这可能证明开发多种量身定制的性传播感染检测模型是合理的。早期的- 调查员领导的小组在招募黑人青年方面拥有广泛的专业知识，将通过以下方式实现这一目标 两个目标：Aim 1将与一个以社区为基础的青年咨询委员会合作建立DCE，该委员会包括 15名来自佐治亚州亚特兰大的黑人男性青少年。定性方法，如访谈、焦点小组和堆积- 排序练习将用于定义最常用的测试属性(例如，测试地点、距离结果的时间 对年轻人很重要；这些属性将被整合到DCE的实验设计中。AIM 2将利用 多平台社区和在线策略招募500名黑人男性的异质样本 青少年参加15分钟的在线DCE。潜在类别分析将被用来阐明偏好 STI测试的异构性，探索具有不同属性偏好的组或类，并评估 相关联的行为/特征。研究方法将植根于DCE最佳实践和 生态系统理论的现象学变体，一个认识到 黑人青年发展起来的。这款R21创新性地探索了人群中日益扩大的健康差距， 在研究中被忽视的。与NICHD战略计划相一致，这项研究将让黑人青少年男性参与 性传播感染服务对支持她们自己和伴侣的性健康至关重要。未来的研究将创造和测试 不同的性传播感染检测模式在提高青少年检测率方面的可接受性和成本效益。