A Family-Based HIV-Prevention Intervention for Youth on ProbationA Family-ba

描述(由申请人提供)：少年司法系统(JJS)的青年由于许多个人和背景风险因素(如家庭、同龄人、邻居)而面临感染艾滋病毒的巨大风险。然而，很少有干预措施旨在解决它们的实质性风险状况。调查员的长期职业目标是成为一名独立研究人员，致力于制定和评估艾滋病毒/性传播感染干预措施，以应对最脆弱青年(例如JJS青年)的更大风险背景。这项K01奖申请侧重于培养研究人员与缓刑系统社区(即缓刑青年、照顾者和缓刑工作人员)合作开发、实施和试点以家庭为基础的艾滋病毒/性传播感染干预措施所需的研究技能。所有活动将由NIH资助的研究人员组成的多学科团队指导，他们在了解艾滋病毒风险的背景、在JJS工作以及为高危青年开发基于家庭的艾滋病毒预防干预措施方面拥有数十年的经验。在NIMH致力于减少和预防艾滋病毒20多年的研究中心，艾滋病毒临床和行为研究中心，PI将获得该中心的资源、研究核心和科学教师，以完成与PIS导师密切协商制定的四个培训目标：1)加强与高危青少年基于家庭的艾滋病毒/性传播感染预防干预相关的行为改变生态学理论和经验性验证的方法的知识；2)学习社区研究的理论原则和方法，将用于制定有针对性的基于家庭的艾滋病毒预防干预措施；3)在收集和分析定性数据方面获得专门知识，这些数据将为艾滋病毒/性传播感染风险评估和随后的干预发展提供信息；以及4)在行为干预试验的设计、方法和统计分析方面获得高级知识和技能。每个研究目标都与培训目标直接相关；研究目的是：1)确定青年在缓刑期间减少艾滋病毒/性传播感染风险的需求，并了解两个缓刑中心的逻辑和体制-文化背景因素，以便为JJS青少年制定基于家庭的艾滋病毒/STI干预措施；2)与缓刑社区一起制定针对JJS青少年的基于家庭的HIV/STI干预措施，方法是对JS青少年采用仅针对青年的艾滋病毒/STI干预措施，并整合来自目标1的形成数据和有效的基于家庭的艾滋病毒/STI干预措施的要素；3)对36个家庭进行以家庭为基础的HIV预防干预试验，随机分为干预和延迟干预两种情况，以：a)检查干预的可行性和可接受性；b)为更大的行为干预试验建立估计的干预参数；以及c)探索干预的潜力，以减少青少年HIV/STI危险行为。缓刑青少年的HIV/STI危险行为不仅是一个矫正问题，也是一个公共卫生问题。有了正确的工具并得到家人的帮助，缓刑青年将更有能力做出更安全的决定，减少艾滋病毒在其社区的传播。 与公共卫生相关：少年司法系统中的青年感染艾滋病毒/性传播疾病的风险很大。在美国，任何一天都有50万缓刑青年居住在他们的社区，缓刑青年的艾滋病毒/性传播危险行为不仅是一个矫正问题，也是一个公共卫生问题。最近的工作强调了以家庭等更广泛的风险背景为目标的重要性，以便更有效地减少最脆弱青年的艾滋病毒/性传播感染危险行为。这一职业发展奖为调查员提供了新的生态途径和方法方面的专门知识，用于制定、实施和评估JJS以家庭为基础的青年艾滋病毒干预措施。这样的培训将允许为JJS青少年制定创新的艾滋病毒/性传播感染预防计划，该计划：1)针对性风险、药物使用和精神健康问题；2)通过针对家庭风险和保护因素解决更大的背景；以及3)积极与缓刑社区合作制定和实施干预措施。

DESCRIPTION (provided by applicant): Youth in the juvenile justice system (JJS) are at substantial risk for HIV due to numerous individual and contextual risk factors (e.g. family, peers, neighborhood). Yet there are few interventions designed to address their substantial profile of risk. The Investigator's long-term career goals are to become an independent researcher dedicated to developing and evaluating HIV/STI interventions that address the larger context of risk for the most vulnerable youth (e.g. JJS youth). This K01 Award application focuses on building the Investigators research skills necessary to work with the probation system community (i.e. youth on probation, caregivers and probation staff) to develop, implement, and pilot test of a family-based HIV/STI intervention. All activities will be mentored by a multidisciplinary team of NIH-funded researchers who together have decades of experience in understanding contexts of HIV risk, working within the JJS, and developing family-based HIV prevention interventions for high risk youth. Embedded in an NIMH research center devoted to reducing and preventing HIV for over 20 years, the HIV Center of Clinical and Behavioral Research, the PI will have access to the Center's resources, research cores, and scientific faculty to accomplish four training objectives that have been developed in close consultation with the PIs mentors: 1) strengthen knowledge of ecological theories of behavior change and empirically validated approaches associated with family-based HIV/STI prevention interventions for high risk youth; 2) learn theoretical principles and methods of community-based research that will be used to develop a targeted family-based HIV-prevention intervention; 3) gain expertise in the collection and analysis of qualitative data that will inform the assessment of HIV/STI risk and subsequent intervention development; and 4) acquire advanced knowledge and skills in the design, methods and statistical analysis of behavioral intervention trials. Each research aim is directly linked with the training objectives; the research aims are: 1) to identify the HIV/STI risk reduction needs of youth on probation and understand logistic and institutional-cultural contextual factors of two probation centers to inform the development of a family-based HIV/STI intervention for JJS youth; 2) to develop with the probation community a family-based HIV/STI intervention for youth on probation by adapting a youth-only HIV/STI intervention for JJS youth and integrating formative data from Aim 1 and elements of efficacious family-based HIV/STI interventions; 3) to pilot test a family-based HIV prevention intervention with 36 families, randomized to intervention or delayed intervention conditions, to: a)examine the feasibility and acceptability of the intervention; b) establish estimated intervention parameters for a larger behavioral intervention trial; and c)explore the potential of the intervention to reduce youth HIV/STI risk behavior. The HIV/STI risk behavior of youth on probation is not just a correctional problem but also a public health concern. Empowered with the right tools and assisted by their families, youth on probation will be better equipped to make safer decisions that reduce the spread of HIV in their communities. PUBLIC HEALTH RELEVANCE: Youth in the juvenile justice system (JJS) are at substantial risk for HIV/STIs. With half a million youth on probation in the US on any given day residing in their communities, the HIV/STI risk behavior of youth on probation is not just a correctional problem but also a public health concern. Recent work has highlighted the importance of targeting the broader context of risk, such as the family, in order to more effectively reduce HIV/STI risk behaviors in the most vulnerable youth. This Career Development Award provides the Investigator with new expertise in ecological approaches and methods for HIV/STI prevention intervention development, implementation and evaluation of a family-based HIV intervention for youth in the JJS. Such training will permit the development of an innovative HIV/STI prevention program for JJS youth that: 1) targets sexual risk, substance use and mental health problems; 2) addresses the larger context by targeting family risk and protective factors; and 3) actively partners with probation community in intervention development and implementation.