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

描述（由申请人提供）：由于许多个人和环境风险因素（例如家庭，同龄人，邻居），青少年司法系统（JJS）中的青少年面临着感染艾滋病毒的巨大风险。然而，很少有干预措施旨在解决其巨大的风险。研究者的长期职业目标是成为一名独立的研究人员，致力于开发和评估艾滋病毒/性传播感染干预措施，以解决最脆弱青年（如JJS青年）面临的更大风险。这项K01奖申请的重点是培养调查员与缓刑系统社区（即缓刑青年、护理人员和缓刑工作人员）合作所需的研究技能，以制定、实施和试点基于家庭的艾滋病毒/性传播感染干预措施。所有活动都将由一个由美国国立卫生研究院资助的多学科研究人员组成的团队进行指导，这些研究人员在了解艾滋病毒风险背景、在JJS内工作以及为高风险青年制定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的研究中心，艾滋病临床和行为研究中心已经有20多年的历史，私家侦探将获得该中心的资源、研究核心和科学教师，以完成与私家侦探导师密切协商制定的四个培训目标：1)加强对行为改变的生态学理论和经验验证方法的认识，这些方法与基于家庭的艾滋病毒/性传播感染预防干预有关；2)学习社区研究的理论原则和方法，用于制定有针对性的以家庭为基础的艾滋病毒预防干预措施；3)获得收集和分析定性数据方面的专业知识，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措施制定提供信息；4)掌握行为干预试验的设计、方法和统计分析方面的先进知识和技能。每个研究目标都与培训目标直接相关；本研究的目的是：1)确定缓刑青少年的HIV/STI风险降低需求，了解两个缓刑中心的后勤和制度文化背景因素，为JJS青少年基于家庭的HIV/STI干预提供信息；2)通过对JJS青少年进行仅针对青少年的艾滋病毒/性传播感染干预，并整合目标1的形成性数据和有效的以家庭为基础的艾滋病毒/性传播感染干预的要素，与缓刑社区一起开发以家庭为基础的缓刑青少年艾滋病毒/性传播感染干预；3)对36个家庭进行以家庭为基础的艾滋病毒预防干预的试点试验，随机分为干预组或延迟干预组，以：a)检查干预的可行性和可接受性；B)为更大规模的行为干预试验建立估计的干预参数；c)探索干预措施在减少青少年艾滋病毒/性传播感染风险行为方面的潜力。缓刑青少年的艾滋病毒/性传播感染危险行为不仅是一个惩教问题，也是一个公共卫生问题。有了正确的工具并得到家人的协助，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。

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.