EVALUATING INTERACTIVE VIDEO PLUS COUNSELING FOR ADOLESCENT STD PREVENTION

评估交互式视频和青少年性病预防咨询

• 批准号: 6229080
• 负责人: JONATHAN HOWLAND
• 金额: $ 11.63万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6229080
• 关键词: Chlamydia trachomatis; adolescence (12-20); behavior therapy; behavioral /social science research tag; clinical research; clinical trials; condoms; cooperative study; counseling; disease /disorder prevention /control; human subject; sex behavior; sexually transmitted diseases; urban area; videotape /videodisc

This five-year study proposes to develop and evaluate an educational intervention to prevent STDs among sexually active inner-city youth using the services of two Boston adolescent clinics. (Boston Medical Center and Children's Hospital). A randomized controlled trial involving an experimental group (N=1938) and a routine care group (N=1938) will be used to test the efficacy of a 15-minute interactive video in combination with a 15-minute interactive counseling session delivered by a trained health educator. Several characteristics distinguish this study. First, the intervention will be designed to deliver individualized content depending upon the adolescent's age, gender, intentions with respect of sexual activity (secondary abstinence or continued sexual activity), and stage of change with regard to adoption of consistent condom use. The individualization takes place within both the video and counseling components of the intervention. Second, evaluation of the intervention will be based on a biological marker for consistent condom use- Chlamydia infection-along with behavioral measures, as opposed to self- reported behavioral measures alone. The intervention builds upon Social Cognitive Theory, and person-to-person counseling. The video component will involve multiple modules tailored to the characteristics of participants. Within the interactive video, the participant will be free to select the sequence of content according to the salience of topics. The structure of the counseling session reflects this approach as well. The participant selects from a menu of topic and determines the order with which content is discussed. Third, the intervention will use booster sessions to enhance effectiveness over time. Fourth, intervention effectiveness will be assessed at six-week, six-month, and one-year follow-up visits. Non-invasive (urine) methods will be used to determine disease (Chlamydia) status at each follow-up. RNA messenger analysis will be used at six week follow-up to distinguish between active Chlamydia infection and residual DNA, for those participants with infection at enrollment. Fifth, a computer-based data collection system will be developed to enhance the validity of self-reported behavioral and attitudinal measures. Our hypothesis is that, relative to controls, intervention participants will evidence at 6-month and one-year follow-up a 25% differences (12% versus 9%) in Chlamydia infection rates.

这项为期五年的研究建议开发和评估教育干预，以防止性活跃的内城青年使用波士顿青少年诊所的服务性病。（波士顿医疗中心和儿童医院）一项涉及实验组（N=1938）和常规护理组（N=1938）的随机对照试验将用于测试15分钟互动视频与15分钟互动咨询会议的有效性，该会议由训练有素的健康教育工作者提供。这项研究有几个特点。首先，干预措施将根据青少年的年龄、性别、性活动意图（二次禁欲或继续性活动）以及坚持使用避孕套的变化阶段，提供个性化内容。个性化发生在视频和咨询干预的组成部分。第二，对干预措施的评估将基于持续使用避孕套的生物标志物-衣原体感染-以及行为测量，而不是单独的自我报告行为测量。这种干预建立在社会认知理论和人对人咨询的基础上。视频部分将涉及针对与会者特点的多个模块。在互动视频中，参与者将根据主题的重要性自由选择内容的顺序。咨询会议的结构也反映了这种方法。参与者从主题菜单中进行选择，并确定讨论内容的顺序。第三，干预将使用助推器会议，以提高有效性随着时间的推移。第四，将在6周、6个月和1年的随访访视时评估干预效果。每次随访时将使用非侵入性（尿液）方法确定疾病（衣原体）状态。对于入组时感染的受试者，将在6周随访时使用RNA信使分析来区分活动性衣原体感染和残留DNA。第五，将开发一个基于计算机的数据收集系统，以提高自我报告的行为和态度措施的有效性。我们的假设是，相对于对照组，干预参与者将在6个月和1年的随访中证明衣原体感染率有25%的差异（12%对9%）。