Investigating change in HIV risk in a self-monitoring diary study

在自我监测日记研究中调查艾滋病毒风险的变化

• 批准号: 8542374
• 负责人: Michael E Newcomb
• 金额: $ 15.45万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8542374
• 关键词: AIDS prevention; AIDS/HIV problem; Adolescent; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Applications Grants; Behavior; Behavioral; Clinical; Cognitive; Control Groups; Data; Data Collection; Dose; Drug usage; Empirical Research; Feedback; Frequencies; Goals; Graph; HIV; HIV risk; Health; Health behavior change; Illicit Drugs; Individual; Infection; Intervention; Lead; Methodology; Monitor; Motivation; Observational Study; Online Systems; Participant; Pattern; Pharmaceutical Preparations; Population; Preventive Intervention; Process; Randomized; Recruitment Activity; Reporting; Research; Research Support; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Self Efficacy; Sex Behavior; Survey Methodology; Technology; Testing; Time; United States; Unsafe Sex; Variant; base; behavior change; binge drinking; cohort; condoms; diaries; emerging adult; experience; individualized feedback; men who have sex with men; programs; research and development; sex; sex risk; social; success; therapy development; tool; young adult

DESCRIPTION (provided by applicant): Young men who have sex with men (YMSM) are profoundly impacted by HIV/AIDS in the United States, but relatively little research has evaluated HIV risk in this population. Notably, binge drinking and illicit drug use have been found to consistently predict sexual risk behavior in YMSM, but few studies have focused on developing interventions for substance-using YMSM. Behavioral diaries are widely-used as a survey method for observing change in health-related behaviors, and behavioral self-monitoring strategies are also frequently used in clinical interventions to induce health-behavior change. Social cognitive processes such as motivation influence the success of self-monitoring, and our previous research found that MSM with greater HIV risk reduction motivation were more likely to reduce their reported unprotected sex over the course of a sexual diary study. However, it is unclear whether motivated MSM simply reduced their sexual risk behavior on their own, or whether they actually benefited from self-monitoring. Despite recent calls to examine the utility of self- monitoring and diary approaches to change sexual risk behavior in YMSM specifically, several important questions remain unanswered: 1) When do sexual diary studies become self-monitoring interventions?; and 2) For whom do self-monitoring diaries serve as interventions? The overarching goal of this study is to examine the conditions under which sexual diaries become self-monitoring interventions for binge-drinking and drug- using YMSM in order to maximize their value as a tool for observation and intervention. To achieve this goal, we will examine the following specific aims: Aim 1: Describe which YMSM, under which situational and contextual conditions, show change in reported sexual risk behavior using web-based behavioral diaries; Aim 2: Experimentally compare frequencies of behavioral diary administration on change in reported sexual risk behavior and participant attrition; and Aim 3: Test the effect of delivering individualized risk behavior feedback. The proposed study will recruit 360 binge-drinking and/or drug-using YMSM (ages 16-29) online into a 2-month web-based sexual diary study. In accordance with Aim 1, we will examine group differences in change in reported sexual risk behavior by age cohort (adolescents, emerging adults, young adults), as well as the influence of social cognitive variables (HIV risk reduction motivation, intentions, and self-efficacy) and substance use (alcohol and illicit drug use) on sexual risk behavior. To achieve Aim 2, we will evaluate differences in reported behavior change and participant attrition by frequency of behavioral diary administration (daily diaries, weekly diarie, or no diaries). For Aim 3, we will test the effect of providing individualized risk behavior feedbak by randomizing YMSM into feedback or no feedback groups. Risk behavior feedback will illustrate: frequency of sexual risk behavior, substance use, and the correlation between these variables. The data collected in this study will aid the PI in transitioning to intervention development research and support a larger grant application to develop a self-monitoring intervention for substance-using YMSM.

描述（由申请人提供）：在美国，与男性发生性关系的年轻男性（YMSM）受到艾滋病毒/艾滋病的深刻影响，但相对较少的研究评估了这一人群的艾滋病毒风险。值得注意的是，酗酒和非法药物的使用被发现可以持续预测YMSM中的性风险行为，但很少有研究专注于开发针对使用物质的YMSM的干预措施。行为日记被广泛用作观察健康相关行为变化的调查方法，行为自我监测策略也经常用于临床干预以诱导健康行为改变。社会认知过程，如动机影响自我监测的成功，我们以前的研究发现，具有更大的艾滋病毒风险降低动机的MSM更有可能在性日记研究过程中减少他们报告的无保护性行为。然而，目前尚不清楚有动机的MSM是否只是自行减少了他们的性风险行为，或者他们是否真正从自我监控中受益。尽管最近有人呼吁研究自我监测和日记方法的效用，以改变YMSM的性风险行为，特别是，几个重要的问题仍然没有答案：1）什么时候性日记研究成为自我监测干预？2）自我监控日记对谁来说是干预措施？本研究的总体目标是检查性日记成为酗酒和吸毒YMSM自我监测干预措施的条件，以最大限度地发挥其作为观察和干预工具的价值。为了实现这一目标，我们将研究以下具体目标：目标1：描述哪些YMSM，在哪些情境和背景条件下，使用基于网络的行为日记显示报告的性风险行为的变化;目标2：实验比较行为日记管理的频率对报告的性风险行为和参与者流失的变化;目标3：测试个性化风险行为反馈的效果。 这项研究将在网上招募360名酗酒和/或吸毒的YMSM（年龄16-29岁），进行为期2个月的基于网络的性日记研究。根据目标1，我们将研究不同年龄组（青少年，新兴成年人，年轻人）报告的性风险行为变化的组间差异，以及社会认知变量（降低艾滋病毒风险的动机，意图和自我效能）和物质使用（酒精和非法药物使用）对性风险行为的影响。为了实现目标2，我们将通过行为日记管理频率（每日日记、每周日记或无日记）评估报告的行为变化和参与者流失的差异。对于目标3，我们将通过将YMSM随机分为反馈组和无反馈组来测试提供个性化风险行为反馈的效果。风险行为反馈将说明：性风险行为的频率，物质使用，以及这些变量之间的相关性。本研究中收集的数据将帮助PI过渡到干预开发研究，并支持更大的赠款申请，以开发使用物质的YMSM的自我监测干预。