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

描述（由申请人提供）：本申请的目的是表明，通过加强招募，参与和保留家庭，参与率和对有艾滋病毒感染风险的非洲裔美国青年（犯罪青少年）的简短家庭干预的有效性可以显着加强。这项拟议的研究将利用“关心的家庭：指导好的选择”（GGC）（又名“为无毒年做准备”）;一种简短有效的家庭干预措施，可增加家庭联系并减少药物使用。我们将尝试通过开发一个增强的协议来优化参与，该协议解决了与招聘，参与和保留有关的背景障碍。增强的协议将包括一个激励DVD的父母，一个激励招聘会议和一个会前会议的家庭讲述他们的故事，并描述他们目前的家庭目标。GGC的有效性将进一步增加定制它与非洲裔美国少年犯罪及其家庭使用。研究将分两个阶段进行。第一阶段将包括GGC的定制和增强协议的开发。第二阶段将对60名目前处于缓刑期的非洲裔美国少年犯罪者及其父母（父母包括一名成年监护人）进行试点测试，这些少年在6所洛杉矶县教育办公室的社区走读学校就读。家庭（试用期的非裔美国学生及其父母）将被随机分配到协议条件（增强协议/GGC或标准协议/GGC），并在3个月时进行监测。本研究的目的是：1.）制定一个增强的协议，招募，参与和保留非裔美国少年犯在缓刑学校和他们的父母在GGC; 2.）通过定性焦点小组和关键知情人访谈，研究GGC对新人群（缓刑学校的非裔美国青少年及其父母）的适当性，如管理人员，教师，学生和家长所认为的那样;和3.）采用随机两组设计，对增强方案和GGC进行初步测试，以评估增强方案在实现最佳招募、参与和保留方面的有效性，并初步检查GGC改善家庭功能、心理健康和问题行为（HIV风险行为、学校表现和累犯）的有效性。 公共卫生相关性非裔美国人处于长期负面的HIV相关结果的高风险中（安德森和史密斯，2005年;疾病控制和预防中心，2005年; Shavers-Hornovich等人，1997年）以及缓刑期的犯罪青少年（Morris等人，1995年），以及在少年司法系统内外循环的犯罪青少年（Benda等人，2001年）。最近取得成功的努力表明，个人重点预防工作需要嵌入更广泛的社会背景，如家庭系统，以维持行为改变（Lightfoot等人，2006; Rotheram-Borus，2005; Pequegnat等人，2001年; Boeon-Franklin等人，2001).这个R21应用程序的目标是表明，通过加强招募，参与和保留的家庭，参与率，并在非洲裔美国青年在艾滋病毒感染的风险，以证据为基础的简短的家庭干预的有效性可以显着加强。

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.