Web-based Family Prevention of Alcohol and Risky Sex for Older Teens

描述(由申请人提供)：有必要对年龄较大的青少年(16-17岁)进行干预，他们正在从事酒精和/或性危险行为。年龄较大的青少年变得更加自主，父母的角色变得更加困难，因为他们在提供指导和放弃控制之间取得平衡。家长们正在努力寻找监控和指导的正确组合。如果以家庭为基础的方法来解决这些青少年的行为是有效的，这个新的计划可能会提供一个低成本和重要的战略，以改善较大的青少年的健康和安全。这项研究将为16-17岁的青少年及其父母开发一种基于网络的干预措施。具体目标1：调整两种以家长为基础的预防战略(家庭事务和家长手册)，以提供一种以家庭为基础的方法，以网络为方案交付方式，解决年龄较大的青少年与酒精有关的危险行为和性危险行为以及结合酒精使用的性行为(以下称为酒精和/或性危险行为)。具体目标2：测试接触该计划是否会导致目标青少年信念和行为的预期变化，包括减少酒精和/或性危险行为。具体目标3：检查程序对青少年酒精和/或性危险行为的影响是否通过中间程序目标信念(父母和青少年)和行为(父母-青少年-沟通)的变化来调节。计划保真度和流程措施也可能调解这些结果。第一阶段整合和调整这两种以家长为基础的方法，并创建基于网络的交互式材料交付。专家小组、焦点小组和可用性评估将为该过程提供信息。第二阶段是一项有500个家庭参加的网络干预的随机对照试验。调查将在基线上进行，并在三个后续时期(6、12和18个月)进行。分析将检查青少年与酒精和/或性危险行为有关的结果。将审查受该计划直接影响的青少年和父母的调解人的变化。将收集和评估流程和保真度信息。 公共卫生相关性：随着青少年年龄的增长，终生饮酒的流行率增加，据国家估计，到12年级时，82.8%的青少年饮酒，62.3%的青少年有过性行为。父母是社会基础设施的重要组成部分，为青少年提供这些行为的指导。开发一种通过网络提供的干预措施提供了一种可行且易于传播的方法。

DESCRIPTION (provided by applicant): There is a need for interventions for older teens (16-17) who are engaging in alcohol and/or sexual risk behaviors. Older teens become more autonomous and the role of the parent becomes more difficult as they balance providing guidance while relinquishing control. Parents struggle with the right mix of monitoring and guidance. If a family-based approach to address these teen behaviors is effective, this new program could potentially provide a low cost and important strategy for improving the health and safety of older teens. This study will develop a web-based intervention for 16-17 year old youth and their parents. The aims are as follows: Specific Aim 1: To adapt two parent-based prevention strategies (Family Matters and Parent Handbook) to provide a family-based approach for addressing older teen alcohol related risk behaviors and sexual risk behaviors and sex in combination with alcohol use (hereafter called alcohol and/or sexual risk behaviors) using the web as the program delivery mode. Specific Aim 2: To test whether exposure to the program leads to expected changes in targeted teen beliefs and behaviors, including reductions in alcohol and/or sexual risk behaviors. Specific Aim 3: To examine whether program effects on teen alcohol and/or sexual risk behaviors are mediated through changes in intermediate program targeted beliefs (parents and teen) and behaviors (parent-teen--communication). Program fidelity and process measures may also mediate these outcomes. Phase I integrate and adapt the two parent-based approaches and creates a web-based interactive delivery of materials. Expert panels, focus groups, and usability assessments will inform the process. Phase II is an RCT with 500 families with the web-based intervention. Surveys will be conducted at baseline, and for three follow-up periods (6, 12, & 18 months). Analyses will examine teen outcomes related to alcohol and/or sexual risk behaviors. Changes in mediators directly impacted by the program for both teens and parents will be examined. Process and fidelity information will be collected and assessed. PUBLIC HEALTH RELEVANCE: Prevalence of lifetime alcohol use increases as teens get older, with national estimates indicating by 12th grade 82.8% of teens have consumed alcohol, 62.3% have engaged in sex. Parents are an important part of the societal infrastructure to provide teens with guidance on these behaviors. Developing an intervention delivered over the web provides a feasible and easily disseminated approach.