CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females

CHOICES-TEEN：针对青少年司法女性的捆绑风险降低干预措施的功效

• 批准号: 10596634
• 负责人: Danielle Elizabeth Parrish
• 金额: $ 62.4万
• 依托单位: BAYLOR UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596634
• 关键词: Address; Adolescent; Adult; Affect; Alcohol consumption; Alcohols; Behavior; Behavior Therapy; Behavioral; Cognitive; Communities; Conceptions; Criminal Justice; Development; Diversion Program; Ethnic Origin; Female; Female Adolescents; Female of child bearing age; Gender; Goals; HIV; Health; Health behavior change; Individual; Infection; Informal Social Control; Intervention; Journals; Justice; Low Prevalence; Marijuana; Mediating; Mediator; Minority; Mobile Health Application; Motivation; Nature; Pilot Projects; Population; Pregnancy; Process; Public Health; Race; Readiness; Recording of previous events; Reporting; Research; Risk; Risk Behaviors; Risk Reduction; Services; Sexually Transmitted Diseases; Teenagers; Testing; Theoretical model; Time; Tobacco; Underserved Population; Vulnerable Populations; Woman; Work; Youth; alcohol exposure; alcohol risk; alcohol risk reduction; behavior change; condoms; consistent condom use; design; efficacy evaluation; efficacy testing; efficacy trial; ethnic minority; follow-up; high risk; improved; infection risk; juvenile justice system; male; marijuana cessation; marijuana use; motivational enhancement therapy; nicotine use; peer; post intervention; pregnant; prevent; preventive intervention; probation; programs; racial diversity; racial population; reduced alcohol use; sexual risk behavior; sexually active; skills; societal costs; standard care; substance use; substance use prevention; therapy design; unintended pregnancy; web site; young woman

PROJECT SUMMARY/ABSTRACT NOT-DA-19-048 Adolescent females in juvenile justice settings engage in multiple health risk behaviors that place them at risk for HIV and pregnancy affected by alcohol and marijuana. Specifically, they engage in frequent sexual risk behaviors, placing them at risk of pregnancy, STIs and HIV, while also using marijuana, and alcohol. With nearly half of U.S. pregnancies being unplanned, females unaware of their pregnancy will continue to drink or use marijuana during the early and critical weeks of gestation, which places them at risk of substance-exposed pregnancy. The long-term goal of this proposed line of research is to develop efficient and opportunistic interventions that reduce the risk of substance-exposed pregnancy (SEP) and HIV/STIs for justice involved female youth. Therefore, the overall objective of this study is to test the efficacy of CHOICES-TEEN (CT) for reducing the risks of SEP and HIV/STI in young women involved in community probation or diversion programs. CT was adapted from the CHOICES preconception intervention and its shorter version, CHOICES-PLUS, which have a robust history of efficacy in reducing the risk of alcohol and tobacco-exposed pregnancy with high-risk adult women. CT utilizes Motivational Interviewing (MI), which has demonstrated significant promise with adolescents and criminal justice populations. Our recent pilot study (R03DA034099; CHOICES-TEEN; CT-P), in which we adapted CHOICES for teens and tested its feasibility with youth on community probation, produced promising results. CT was modified based on this pilot work to 1) focus on marijuana (reported by 89% in CT-P study) rather than tobacco given the low prevalence and sporadic nature of nicotine use reported by the teens; 2) add a mobile health application to increase engagement with the daily journal and; 3) incorporate a post-CT self-regulation component targeting behavioral processes of change (POC). This study will move the field vertically by elucidating important factors influencing youth health behavior change, while testing an intervention designed to reduce individual and societal costs for this high risk, underserved adolescent population. The next logical step is to conduct a rigorous RCT to assess the efficacy of this gender-responsive, tailored bundled risk reduction intervention for young, primarily minority, women involved in a community-based juvenile justice diversion or probation program. A stage II behavioral intervention efficacy trial will: 1) Primary Aim: Test the efficacy of CHOICES-TEEN (CT) on reducing the risk of substance-exposed pregnancy (SEP) and HIV/STI among high-risk female youth involved with the juvenile justice system by reducing alcohol use, increasing marijuana cessation, reducing pregnancy risk, and increasing condom use. Aim 2: Test the efficacy of CT, compared to SC, in increasing cognitive self-regulation abilities; Aim 3: Test proposed intervention mediators/mechanisms of action for CT overall and by race/ethnicity; Aim 4: Test the moderating effect of initial readiness to change on risk of SEP and risk of HIV/STI. If efficacious, CT is readily scalable and has the potential for dissemination not only to juvenile justice settings, but to a wealth of settings that serve young adolescent women at risk of substance-exposed pregnancies and HIV/STI.

项目摘要/摘要 NOT-DA-19-048青少年司法环境中的青少年女性从事多种健康危险行为， 他们面临感染艾滋病毒和怀孕的风险，受到酒精和大麻的影响。具体地说，他们经常发生性行为 危险行为，使她们面临怀孕、性传播感染和艾滋病毒的风险，同时还使用大麻和酒精。使用 近一半的美国意外怀孕，女性在不知道自己怀孕的情况下将继续饮酒或使用 在怀孕早期和关键的几周内吸食大麻，这使他们面临接触物质的风险 怀孕了。这一拟议研究路线的长期目标是开发高效和机会主义的 减少药物暴露妊娠(SEP)和艾滋病毒/性传播感染风险的干预措施涉及女性 青春年华。因此，这项研究的总体目标是测试CHOICES-TEN(CT)对减少 参与社区缓刑或分流计划的年轻女性的SEP和艾滋病毒/性传播感染风险。CT被改编成 从选择先入为主的干预及其较短的版本，选择加，这具有强大的 在降低高危成年妇女接触酒精和烟草的怀孕风险方面的有效性历史。CT 利用动机访谈(MI)，这在青少年和罪犯中表现出了重大的前景 正义的人群。我们最近的试点研究(R03DA034099；Options-TEND；CT-P)，在该研究中，我们适应了 对青少年的选择进行了评估，并对青少年社区缓刑的可行性进行了测试，取得了令人振奋的结果。CT 在此试点工作的基础上进行了修改，以1)专注于大麻(CT-P研究中89%的人报告)，而不是烟草 鉴于青少年报告的尼古丁使用的低流行率和零星性质；2)增加移动健康 应用程序增加与日报的接触；3)纳入CT后自我调节部分 针对行为变化过程(POC)。这项研究将通过阐明重要的 影响青年健康行为变化的因素，同时测试旨在减少个人和 对这一高风险、未得到充分服务的青少年群体来说，这是一种社会代价。下一个合乎逻辑的步骤是进行严格的 RCT，以评估这一针对年轻人的性别敏感、量身定制的捆绑降低风险干预措施的有效性， 主要是参与以社区为基础的少年司法转移或缓刑计划的少数族裔妇女。A阶段II 行为干预有效性试验将：1)主要目标：测试选择的有效性-青少年(CT)对减少 与青少年有关的高危女青年的物质暴露妊娠(SEP)和艾滋病毒/性传播感染风险 通过减少酒精使用、增加大麻戒断、降低怀孕风险和增加 使用避孕套。目标2：与SC相比，测试CT在提高认知自我调节能力方面的有效性；目标3： 全面和按种族/族裔测试针对CT的拟议干预调解人/行动机制；目标4：测试 初步准备改变对SEP风险和HIV/STI风险的调节作用。如果有效，CT很容易就能做到 可扩展，并有可能不仅传播到青少年司法环境，而且传播到丰富的 为有接触物质怀孕和艾滋病毒/性传播感染风险的年轻少女提供服务。