Computer-Aided Counseling to Prevent Teen Pregnancy/STDs

描述（由研究者提供）：青少年意外妊娠和 性病在美国仍处于流行水平。健康人2010 目标设定了一个目标，将性行为的比例提高到90%， 积极使用避孕措施的青少年， 怀孕和提供屏障保护免受疾病。如何有效 辅导青少年实现这一目标的途径尚不明确。咨询和反馈 基于跨理论模型（TTM）的研究取得了更大的成功 而不是标准的、以行动为导向的建议。 这种类型的咨询改变女性青少年的有效性 性行为和避孕行为尚未得到严格评估。我们 建议招募660名年龄在13至21岁之间的女性青少年， 市中心，医院为基础的诊所，并随机将他们分为一个创新的 计算机辅助动机干预（CAMI）或教学教育 控制（DEC）。摄像机!小组将接受三次30分钟的会议， 一对一的咨询与辅导员是由计算机生成的指导， 个性化反馈。CAMI基于TTM的原则， 动机面试DEC提供三个30分钟的会议， 一对一的关于避孕、性病预防的教育信息， 禁欲这两种干预措施在时间和长度上是相同的，但有所不同。 在教育内容、辅导方式和提供个性化 反馈我们将在这项研究中跟踪两组女性青少年 通过6个月的干预阶段和12个月的随访阶段， 不同群体的性行为和避孕行为的差异。 该研究的主要具体目的是评估CAMI的疗效 与DEC相比，在减少性行为方面， 意外怀孕和性病我们将检查保护性的性行为 在三个方面：1）防止怀孕的行为; 2） 预防性传播疾病; 3）预防怀孕和 性病我们的主要假设是，CAMI将减少 受试者进行任何性交， 怀孕和预防性病。我们还预测在性活跃的人群中 受试者，CAMI将增加性交事件的百分比， 通过使用两个避孕套和另一种避孕药得到很好的保护。 最后，我们还预测，CAMI将增加 在整个样本中禁欲。如果证明有效，计算机辅助 个性化的动机咨询可以广泛地作为一种方法来实施， 降低女性意外怀孕和性传播疾病的发生率 青少年。

DESCRIPTION (provided by investigator): Adolescent unintended pregnancy and STDs remain at epidemic levels in the United States. Healthy People 2010 Objectives set a goal to increase to 90 percent the proportion of sexually active adolescents who use contraception that both effectively prevents pregnancy and provides barrier protection against disease. How to effectively counsel adolescents to reach this goal is unclear. Counseling and feedback based on the Transtheoretical Model (TTM) have demonstrated greater success than standard, action-oriented advice in several domains of behavior change. The effectiveness of this type of counseling to alter female adolescents' sexual and contraceptive behaviors has not been rigorously evaluated. We propose recruiting 660 female adolescents, ages 13 to 21 years, from an inner-city, hospital-based clinic and randomizing them to either an innovative Computer-Assisted Motivational Intervention (CAMI) or a Didactic Educational Control (DEC). The CAM! group will receive three, 30-minute sessions of one-on-one counseling with a counselor that is guided by computer-generated personalized feedback. The CAMI is based on the principles of the TTM and on Motivational Interviewing. The DEC provides three 30-minute sessions of one-on-one didactic information on contraception, STD prevention, and abstinence. The two interventions are identical in length and timing but vary in educational content, counseling style, and the provision of personalized feedback. We will track the two groups of female adolescents in this study through a 6-month intervention phase and a 12-month follow-up phase to assess differences in sexual and contraceptive behaviors by group. The primary specific aim for the study is to evaluate the efficacy of the CAMI as compared to the DEC in reducing sexual behaviors that increase the risks of both unintended pregnancy and STDs. We will examine protective sexual behaviors in three ways: 1) behaviors that protect against pregnancy; 2) behaviors that protect against STDs; and 3) behaviors that protect against both pregnancy and STDs. Our primary hypothesis is that the CAMI will decrease the proportion of subjects who engage in any intercourse that is poorly protected against pregnancy and against STDs. We also predict that among sexually active subjects, the CAMI will increase the percentage of episodes of intercourse that are well protected by the use of both condoms plus another contraceptive. Finally, we also predict that the CAMI will increase the prevalence of abstinence among the entire sample. If proven effective, computer-assisted personalized motivational counseling could be broadly implemented as a method to decrease the incidence of unintended pregnancy and STDs among female adolescents.