STD PREVENTION FOR AT RISK AFRICAN-AMERICAN WOMEN

针对高危非裔美国女性的性病预防

• 批准号: 6186896
• 负责人: Lucy NELLE Marion
• 金额: $ 72.07万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 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 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6186896
• 关键词: AIDS /HIV test; African American; HIV infections; behavioral /social science research tag; clinical research; communicable disease control; counseling; female; health behavior; human subject; human therapy evaluation; low socioeconomic status; nursing intervention; sex behavior; sexually transmitted diseases; substance abuse related behavior; women's health; young adult human (21-34)

The purpose of the study is to test the effectiveness of a 12-month multi-modal Well Woman intervention to prevent new sexually transmitted diseases (STDs) among young, low-income African American women with a history of repeated STDs. The target group lives on or near the Chicago Westside, where women are plagued with some of the highest STD rates in the nation. The Specific Aim is to determine the effects of the randomized, controlled repeated measures trial on (a) the mediating outcomes--STD related social, psychological, and skill/behavioral factors, and (b) the health status outcome-laboratory-confirmed newly contracted STDs. The intervention is case-managed by advanced practice nurses (APNs) and complemented by a social worker and peer educators. The intervention has a 2 month intensive phase and a 10-month maintenance phase with evidence- based standardized and individualized STD-prevention strategies: STD diagnosis, treatment, teaching, and support by APNs; STD prevention classes led by peer educators; community referrals and retention strategies by a social worker; and partner classes, counseling, and referrals. Subjects will be 670 women aged 18-29 years who have an index STD and at least 1 other STD in their histories. Subject recruitment will occur at 4 publicly supported West Side clinics, and the intervention will be in the West Side Health Center, a new Cook County Health Services facility in the center of the area. After baseline measures, the women will be randomly assigned to control or intervention groups with the minimization subject distribution procedure, taking into account the history of intravenous drug use, number of sexual partners, sexual violence, and HIV seropositivity. The control group will have usual care, STD urine screening, HIV testing (offered) and a minimal didactic experience until the 12-month measure is taken. Then they will be offered a concentrated intervention. A STD-Prevention Framework derived from a tested nursing model, Cox's Interaction Model of Client Health Behavior, will guide the overall intervention and the components. Analyses include change scores, logistic regression, proportional odds regression and random regression analysis.

这项研究的目的是测试12个月的多模式妇女干预措施的有效性，以防止年轻，低收入的非洲裔美国妇女反复性传播疾病（性病）的历史。 目标群体居住在芝加哥西区或附近，那里的妇女受到全国一些最高性病发病率的困扰。具体目的是确定随机对照重复测量试验对（a）中介结果--STD相关的社会、心理和技能/行为因素，和（B）健康状况结果--实验室确认的新感染STD的影响。 干预措施由高级执业护士（APN）进行个案管理，并由社会工作者和同伴教育者进行补充。 干预包括2个月的强化阶段和10个月的维持阶段，采用基于证据的标准化和个性化的性病预防策略：由APN进行性病诊断、治疗、教学和支持;由同伴教育者领导的性病预防课程;由社会工作者进行的社区转介和保留策略;以及伴侣课程、咨询和转介。 受试者将是670名年龄在18-29岁之间的女性，她们在病史中患有指示性STD和至少1种其他STD。 受试者招募将在4个公共支持的西区诊所进行，干预将在西区健康中心进行，这是该地区中心的一个新的库克县健康服务设施。 在基线测量后，考虑到静脉吸毒史、性伴侣数量、性暴力和艾滋病毒血清阳性，将妇女随机分配到对照组或干预组，采用最小化受试者分布程序。 对照组将接受常规护理、STD尿液筛查、HIV检测（提供）和最低限度的教学经验，直到采取12个月的措施。 然后，他们将得到集中干预。 性病预防框架来自一个经过测试的护理模式，考克斯的客户健康行为的互动模式，将指导整体干预和组成部分。 分析包括变化评分、逻辑回归、比例优势回归和随机回归分析。