Evidence-based sexual and reproductive health intervention using a multiphase optimization strategy

使用多阶段优化策略进行循证性健康和生殖健康干预

• 批准号: 10896494
• 负责人: Katherine Gannett Merrill
• 金额: $ 24.82万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-11 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10896494
• 关键词: 18 year old; Acceleration; Acculturation; Address; Adolescent; Adult; Affect; African American; African American population; Award; Awareness; Behavior Therapy; Biological; Chicago; Chlamydia; Communities; Competence; Control Groups; Data Collection; Daughter; Development; Educational workshop; Effectiveness; Effectiveness of Interventions; Ethnic Origin; Evidence based intervention; Evidence based program; Faculty; Family; Feedback; Female Adolescents; Focus Groups; General Population; Goals; Gonorrhea; Grant; HIV/AIDS; Health; Health Promotion; Home environment; Incidence; Individual; Infection; Intervention; Knowledge; Language; Latina; Latina Population; Learning; Link; Literature; Measures; Mediator; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Mothers; Outcome; Parents; Phase; Population Heterogeneity; Positioning Attribute; Pregnancy in Adolescence; Preparation; Process; Publishing; Randomized, Controlled Trials; Religion; Research; Research Design; Research Personnel; Risk; Running; Scientist; Sexual Health; Sexually Transmitted Diseases; Shapes; South African; Syphilis; Testing; Training; Translating; Trichomonas; United States; Youth; adolescent health; adolescent health outcomes; adolescent sexual behavior; adverse outcome; behavioral outcome; career; community based participatory research; community organizations; comparison control; contextual factors; design; driving force; effectiveness evaluation; emotion regulation; evidence base; experience; experimental study; girls; health disparity; high risk; high risk sexual behavior; implementation intervention; implementation science; innovation; interest; intervention mapping; intimate partner violence; meetings; multiphase optimization strategy; peer; pilot test; primary outcome; programs; reproductive health intervention; scale up; secondary outcome; sexual health intervention; substance use; symposium; tenure track; theories; tool

ABSTRACT Latina adolescents in the U.S. are disproportionately affected by HIV/AIDS/sexually-transmitted infections (STIs) and other adverse consequences of risky sexual behavior. The home environment is recognized to shape adolescents' health outcomes, but only one Latina mother-daughter sexual health program was identified in the literature. IMARA (Informed, Motivated, Aware, and Responsible Adolescents and Adults) is an evidence-based intervention for African American adolescent girls and their mothers, which is well-suited to be adapted for Latinas. In a randomized controlled trial (RCT) in Chicago, the program reduced the risk of new STIs by 45% compared to the control group among 14-18-year-olds. In this K99/R00 award, I propose to adapt IMARA to a Latina audience and pilot an optimization trial within community-based organizations (CBOs) in Chicago, using the multiphase optimization strategy (MOST). MOST is a methodological framework for developing an optimal intervention package by assessing the effectiveness of an intervention's components prior to subjecting the intervention to an RCT. This grant focuses on the preparation phase of MOST, using an implementation science (IS) approach and drawing on community-based participatory research (CBPR) principles to pursue three specific aims: 1) adapt the intervention for Latinas by establishing a community advisory board and engaging 12 mother-daughter dyads in 4 focus group discussions (K99 phase); 2) establish the acceptability, feasibility, and appropriateness of the intervention components through piloting among 24 new dyads (K99 phase); and 3) pilot an optimization trial of the adapted intervention among 92 new dyads and examine intervention component effects on risky sexual behavior (primary outcome) and STI incidence (secondary outcome) (R00 phase). These research aims will allow me to build on my strong research and publishing experience in adolescent health and capitalize on the expertise of my mentorship team in sexual risk interventions for youth to achieve four training aims, to: 1) gain knowledge in CBPR principles and their application; 2) develop expertise in IS theory/design and its application; 3) learn to employ innovative research designs, analysis strategies, and frameworks for behavioral interventions, including MOST; and 4) further my professional development to obtain a tenure-track faculty position prior to the R00 phase. I will accomplish my training aims through meetings, directed readings, and conference/workshop attendance, with support from my mentors (Primary Mentor: Geri Donenberg). Findings will form the basis of an R01 application for a fully-powered optimization trial to test intervention component impacts on STI incidence among Latina adolescents. The long-term goal is to generate an efficient, sustainable adapted intervention with potential for scale-up with CBOs serving Latinas. This K99/R00 award will give me a platform on which to launch my career as an independent adolescent health researcher, specialized in innovative methods for developing, implementing, and evaluating behavioral interventions.

摘要 美国的拉美裔青少年受艾滋病毒/艾滋病/性传播感染的影响不成比例 (性传播感染)和其他危险性行为的不良后果。家庭环境被认为是 塑造青少年的健康结果，但只有一个拉丁裔母女性健康项目是 在文献中被确认。Imara(见多识广、积极进取、有意识和负责任的青少年和成年人) 对非洲裔美国少女及其母亲的循证干预，这非常适合 为拉丁裔改编的。在芝加哥的一项随机对照试验(RCT)中，该计划降低了新发病的风险 在14-18岁的青少年中，性传播感染比对照组增加了45%。在这个K99/R00奖项中，我提议 使Imara适应拉丁裔受众，并在基于社区的组织中试行优化试验 (CBOS)，使用多阶段优化策略(MOST)。MOST是一种方法论 通过评估干预措施的有效性来制定最优干预方案的框架 在接受随机对照试验之前的所有组成部分。这笔赠款的重点是 大多数情况下，使用实施科学(IS)方法并借鉴基于社区的参与性 研究(CBPR)原则追求三个具体目标：1)通过建立 一个社区咨询委员会，让12对母女参与4个焦点小组讨论(K99 阶段)；2)通过以下方式确定干预组成部分的可接受性、可行性和适当性 在24个新的二联体中进行试点(K99阶段)；以及3)在以下人群中进行适应性干预的优化试验 92个新的二元体，并检查干预成分对危险性行为的影响(主要结果)和 STI发生率(次要结果)(R00期)。这些研究目标将使我能够在我强大的基础上 在青少年健康方面的研究和出版经验，并利用我导师的专业知识 青年性风险干预团队，以实现四个培训目标，以：1)获得CBPR知识 原理及其应用；2)发展信息系统理论/设计及其应用方面的专业知识；3)学习使用 创新的研究设计、分析战略和行为干预框架，包括社会变革管理计划； 以及4)进一步促进我的专业发展，以便在R00阶段之前获得终身教职。我 将通过会议、定向阅读和参加会议/研讨会来实现我的培训目标， 在我导师的支持下(主要导师：Geri Donenberg)。调查结果将构成R01的基础 应用全功率优化试验测试干预成分对性传播感染发病率的影响 在拉丁裔青少年中。长期目标是产生一种有效、可持续的适应性干预 CBO为拉丁裔提供服务，扩大规模的潜力。这个K99/R00奖项将给我一个平台，在这个平台上 作为一名独立的青少年健康研究员开始我的职业生涯，专门研究创新方法 用于开发、实施和评估行为干预。