Recruiting, engaging & retaining families for interventions to prevent HIV transm

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DESCRIPTION (provided by applicant): The goal of this application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of a brief family intervention for African American youth at risk for HIV infection - delinquent adolescents - can be significantly strengthened. The proposed study will utilize "Families that Care: Guiding Good Choices" (GGC) (aka "Preparing for the Drug Free Years"); a brief efficacious family intervention that increases family connectedness and decreases drug use. We will attempt to optimize participation by developing an enhanced protocol that addresses contextual barriers pertaining to recruitment, engagement and retention. The enhanced protocol will include a motivational DVD for parents, a motivational recruitment session and a pre-session for families to tell their stories and describe their current family goals. The efficaciousness of the GGC will be further increased by customizing it for use with African American delinquent adolescents and their families. The research will entail two phases. Phase 1 will encompass the tailoring of GGC and development of the enhanced protocol. Phase 2 will pilot test the enhanced protocol and GGC with 60 African American delinquent adolescents currently on probation who are enrolled in 6 Los Angeles County Office of Education's Community Day Schools and their parents (parents includes an adult guardian). Families (African American students on probation and their parents) will be randomly assigned to a protocol condition (enhanced protocol/GGC or standard protocol/GGC) and monitored at 3 months. The research aims are to: 1.) develop an enhanced protocol for recruiting, engaging and retaining African American delinquent adolescents in probation schools and their parents in GGC; 2.) examine the appropriateness of GGC for a new population (African American delinquent adolescents in probation schools and their parents) as perceived by administrators, teachers, students and parents through qualitative focus groups and key informant interviews; and 3.) pilot test the enhanced protocol and GGC using a randomized two groups design to evaluate the efficacy of the enhanced protocol in achieving optimal recruitment, engagement and retention, and preliminarily examine the efficacy of GGC to improve family functioning, mental health, and problem behaviors (HIV risk behaviors, school performance and recidivism). PUBLIC HEALTH RELEVANCE African Americans are at high risk for long-term negative, HIV-related outcomes (Anderson & Smith, 2005; Centers for Disease Control and Prevention, 2005; Shavers-Hornaday et al., 1997) as are delinquent adolescents on probation (Morris et al., 1995), and delinquent adolescents who cycle in and out of the juvenile justice system (Benda et al., 2001). Recent efforts that have achieved success suggest that individually focused prevention efforts need to be embedded within broader social contexts, such as the family system, to sustain behavior change (Lightfoot et al., 2006; Rotheram-Borus, 2005; Pequegnat et al., 2001; Boyd-Franklin et al., 2001).The goal of this R21 application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of an evidence based brief family intervention for African American youth at risk for HIV infection can be significantly strengthened.