Evidence-based multi level risk reduction for Bahamian mid-adolescents

巴哈马中青少年基于证据的多层次风险降低

• 批准号: 8415912
• 负责人: BONITA FRANCES STANTON
• 金额: $ 18.49万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8415912
• 关键词: 10 year old; AIDS prevention; AIDS/HIV problem; Abstinence; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adolescent; Adolescent Risk Behavior; African; Age; Attention; Bahamas; Behavior; Behavior Control; Behavior Therapy; Behavioral; Caribbean region; Caring; Categories; Cells; Centers for Disease Control and Prevention (U.S.); Child; Clinical Trials Design; Collaborations; Color; Commit; Communication; Consent; Consultations; Country; Data; Decision Making; Developing Countries; Development; Diffusion; Education; Educational Curriculum; Effectiveness; Elements; Enrollment; Environment; Environmental Exposure; Epidemic; Epidemiology; Evaluation; Exhibits; Exposure to; Family health status; Funding; Future; Goals; Government; HIV; HIV Infections; HIV Seroprevalence; HIV risk; Health Policy; Hour; Individual; Intention; Intervention; Knowledge; Learning; Letters; Life; Literature; Meta-Analysis; Motivation; Nature; Pan American Health Organization; Parents; Perception; Persons; Population; Positioning Attribute; Postdoctoral Fellow; Prevalence; Prevention; Prevention Research; Prevention program; Process; Publishing; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Reduction; Safe Sex; Sampling; Schedule; Schools; Students; Subgroup; Testing; Theoretical model; Time; Training; Transportation; Turks and Caicos Islands; UNESCO; Update; Work; Youth; base; career; cohort; condoms; design; effective intervention; eighth grade; elementary school; environmental intervention; evidence base; experience; follow-up; group intervention; high risk; high school; intervention effect; member; middle school; ninth grade; parental involvement; parental monitoring; parental role; post intervention; prevent; programs; protective behavior; response; sex; sex risk; sixth grade; skills; success; teacher; theories; therapy design; young adult

Over the last quarter century, substantial progress has been made in effecting purposeful behavioral change to reduce HIV/AIDS risk. Nevertheless, specific demographic and socio-geographic sub-groups remain at high risk and substantial challenges in maintaining purposeful behavioral change persist. Among those groups remaining at high risk are adolescents and young adults, persons of color, and individuals residing in transitional and developing countries. Challenges that have continued to confront behavioral risk reduction interventions include: a) waning intervention effects over time; b) changing environmental exposures and responses thereto that occur during adolescence; and c) the resource intensive nature of multiple session behavioral interventions especially in resource poor settings such as developing and transitional countries. This competitive renewal of R01MH069229 will focus on a particularly high risk population (youth of African descent attending Grade 10 in government high schools in The Bahamas, a nation with an HIV sero- prevalence of 3%) and proposes a four-cell, randomized, controlled trial designed to address each of the four challenges outlined above, building upon our ongoing research. During the past 4.5 years in our current funding period, the US-Bahamian research team has been evaluating the Bahamian adaptation of a 10- session adolescent HIV prevention program entitled "Focus on Youth in The Caribbean" (FOYC) and the 1- hour adapted parental monitoring intervention entitled "Caribbean Informed Parents and Children Together" (CImPACT) through a randomized, controlled three-celled trial involving 1360 Grade 6 youth and 1175 of their parents. Beginning at the 6 months follow-up and extending through 24 months follow-up, condom-use, condom-use intention, and relevant perceptions and knowledge were significantly higher among FOYC youth compared to control youth. Despite the efficacy of FOYC, the and 36 (preliminary data) actual rates among both FOYC and control youth are concerningly low (e.g. condom-use rates at 24 months and 36 months was 30% and 40% among FOYC youth and 20% and 25% among controls). Therefore, the Department of Education of The Bahamas and the US-Bahamian Research Team seek to identify an effective intervention that can be delivered to Grade 10 students in The Bahamas. In the research described in this submission, we propose to: a) Recruit 2600 youth (and their parents) from 172 Grade 10 FHLE classrooms over two years from all 7 government high schools in New Providence, The Bahamas; b) Randomly assign at the level of the classroom 2400 youth (and their parents) from 160 classes to one of four intervention conditions: 1) HFLE only (no parent intervention); 2) BFOOY only (no parent intervention); 3) BFOOY plus ImPACT (delivered to parent-youth dyads with a six month parent booster); or 4) BFOOY plus GFI (delivered to parent-youth dyads with a six month parent booster); c) Randomly assign one of the seven high schools (with ~12 HFLE classes and ~200 students) to a "control school" condition to explore possible class-to-class contamination within schools; d) Assess intervention effects on the entire sample at 6, 12, 18 and 24 months post-intervention (and among parents at 6 and 12 months); and e) Conduct sub-group analyses to explore: i) the impact of interventions received at two critical junctures during adolescence; ii) the effect of being part of a longitudinal trial on risk/protective behaviors; and iii) the extent of intervention contamination if the unit of randomization is the class rather than the school.

在过去的四分之一个世纪中，在实现有目的的行为改变方面取得了实质性进展 降低艾滋病毒/艾滋病风险。尽管如此，特定的人口和社会地理亚群体仍然处于 维持有目的的行为改变的高风险和重大挑战仍然存在。其中 仍然处于高风险的群体是青少年和年轻人、有色人种以及居住在 转型国家和发展中国家。降低行为风险持续面临的挑战 干预措施包括： a) 干预效果随着时间的推移逐渐减弱； b) 改变环境暴露和 青春期期间发生的反应； c) 多会话的资源密集性质 行为干预，特别是在资源匮乏的环境中，例如发展中国家和转型国家。 R01MH069229 的竞争性更新将重点关注特别高风险人群（青少年） 非洲裔后裔在巴哈马公立高中就读 10 年级，该国存在艾滋病毒血清 患病率为 3%），并提出一项四细胞、随机、对照试验，旨在解决这四个问题中的每一个 上述挑战是基于我们正在进行的研究。在我们目前的过去 4.5 年里 资助期间，美国-巴哈马研究小组一直在评估巴哈马对 10- 题为“关注加勒比地区青年”（FOYC）的青少年艾滋病毒预防计划和 1- 题为“加勒比知情父母和儿童在一起”的小时适应性家长监测干预措施 (CImPACT) 通过一项随机、对照三细胞试验，涉及 1360 名 6 年级青少年和 1175 名青少年 他们的父母。从 6 个月的随访开始，一直持续到 24 个月 月随访，了解安全套使用情况、安全套使用意图以及相关认知和知识 与对照组青年相比，FOYC 青年显着更高。尽管 FOYC 具有功效， 和36（初步数据） FOYC 和对照青少年的实际比率都相当低（例如 24 个月时的安全套使用率） 36 个月在 FOYC 青年中为 30% 和 40%，在对照组中为 20% 和 25%）。因此， 巴哈马教育部和美国-巴哈马研究小组寻求确定一个 可以为巴哈马 10 年级学生提供有效的干预措施。在所描述的研究中 在本次提交中，我们建议： a) 从 172 名 10 年级 FHLE 中招募 2600 名青少年（及其家长） 巴哈马新普罗维登斯所有 7 所公立高中的教室，为期两年； b) 将 160 个班级中的 2400 名青少年（及其家长）随机分配到其中一个班级 四种干预条件： 1）仅 HFLE（无家长干预）； 2) 仅 BFOOY（无家长 干涉）; 3) BFOOY + ImPACT（提供给父母-青少年二人组，并提供六个月的父母助推器）； 或 4) BFOOY 加 GFI（提供给父母-青少年二人组，并提供六个月的父母助推器）； c) 随机 将七所高中之一（约 12 个 HFLE 班级和约 200 名学生）分配给“对照学校” 有条件探索学校内可能存在的班级间污染情况； d) 评估干预效果 干预后 6、12、18 和 24 个月的整个样本（以及 6 和 12 个月的父母）；和 e) 进行亚组分析以探讨： i) 在两个关键时刻采取的干预措施的影响 青春期期间； ii) 参与纵向试验对风险/保护行为的影响；以及 iii) 如果随机化单位是班级而不是学校，则干预污染的程度。

项目成果

Parental Monitoring and Risky Behavior in Bahamian Youth.

巴哈马青少年的父母监督和危险行为。

• DOI: 10.18357/ijcyfs34201211483
• 发表时间: 2012
• 期刊: International journal of child, youth & family studies : IJCYFS
• 作者: Jones,Giavana;Chen,Xinguang;Stanton,Bonita;Dinaj-Koci,Veronica;Deveaux,Lynette;Lunn,Sonja;Brathwaite,Nanika;Gomez,MPerry
• 通讯作者: Gomez,MPerry

Intention to use condom, cusp modeling, and evaluation of an HIV prevention intervention trial.

• 发表时间: 2013-07
• 期刊: Nonlinear dynamics, psychology, and life sciences
• 作者: Xinguang Chen;B. Stanton;Din Chen;Xiaoming Li

Effects on condom use of an HIV prevention programme 36 months postintervention: a cluster randomized controlled trial among Bahamian youth.

• DOI: 10.1258/ijsa.2010.010039
• 发表时间: 2010-09
• 期刊: International journal of STD & AIDS
• 影响因子: 1.4
• 作者: Chen X;Stanton B;Gomez P;Lunn S;Deveaux L;Brathwaite N;Li X;Marshall S;Cottrell L;Harris C
• 通讯作者: Harris C

A quarter century of HIV prevention intervention efforts among children and adolescents across the globe.

四分之一个世纪以来，全球儿童和青少年都在进行艾滋病毒预防干预工作。

• DOI: 10.1080/21642850.2014.889572
• 发表时间: 2014
• 期刊: Health psychology and behavioral medicine
• 影响因子: 2.7
• 作者: Stanton,Bonita;Li,Xiaoming
• 通讯作者: Li,Xiaoming

The impact of youth, family, peer and neighborhood risk factors on developmental trajectories of risk involvement from early through middle adolescence.

青少年、家庭、同伴和邻里风险因素对青春期早期到中期风险参与发展轨迹的影响。

• DOI: 10.1016/j.socscimed.2014.01.023
• 发表时间: 2014
• 期刊: Social science & medicine (1982)
• 作者: Wang,Bo;Deveaux,Lynette;Li,Xiaoming;Marshall,Sharon;Chen,Xinguang;Stanton,Bonita
• 通讯作者: Stanton,Bonita