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.

项目摘要 在2018年新增的2600万例性传播感染（STI）中，近一半发生在青少年（15-19岁）中 年轻人（20-24岁）。数百万病例仍未得到诊断和治疗，特别是 在男性青少年中。不到3%的性活跃男性青少年在过去12个月内进行了STI测试 而女性同龄人的这一比例为26%。男性青少年比女性青少年更有可能放弃测试， 保密问题、成本/保险障碍和较低的自我感知风险。COVID-19加剧了 STI护理的障碍，因为自2020年3月以来，检测服务已经下降了66%。有很大的紧迫性， 制定创新和有效的方法，筛查青少年男性的性传播感染： 如果没有症状，未经治疗的性传播感染可能会在不知不觉中传染给其他性伴侣。未经治疗的性传播感染可 导致男性和女性不育并增加感染艾滋病毒可能性。R21的目标 是使用一种创新的，以用户为中心的方法，一个离散的选择实验，以确定偏好， 性传播感染测试模型在黑人青少年男性。在离散选择实验（DCE）中， 已被广泛用于通知卫生服务的设计/采用，受访者提出了两个 具有不同属性的服务并且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的相对重要性，以及可接受的贸易- offs.重要的是，DCE可以用来突出不同黑人群体中共享但不同的偏好。 青少年男性，这可能证明开发多个，量身定制的性传播感染测试模型是合理的。早期- 调查员领导的小组在招募黑人青年方面具有广泛的专门知识，将通过以下方式实现这一目标： 两个目标：目标1将与社区青年咨询委员会合作建立青年发展中心，该委员会由以下成员组成 15名来自亚特兰大的黑人男性青少年，GA。定性方法，如访谈，焦点小组，和桩- 排序练习将用于定义测试属性（例如，测试地点，直到结果的时间），这是最 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 青少年参加一个15分钟的在线DCE。潜在的类别分析将用于阐明偏好 STI测试的异质性，探索具有不同属性偏好的组或类，并评估 相关行为/特征。研究方法将以DCE最佳实践和 生态系统理论的现象学变体，一个框架，认识到独特的背景下， 黑人青年的发展。R21创新地探讨了人口中日益增长的健康差距， 在研究中被忽视。根据NICHD战略计划，这项研究将使黑人青少年男性参与 性传播感染服务对于支持她们自己及其伴侣的性健康至关重要。未来的研究将创造和测试 各种性传播感染检测模式在提高青年检测率方面的可接受性和成本效益。