Adolescent Risk Reduction in the Peers & Parents

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): HIV/AIDS remains a significant problem in the Caribbean in general, the Bahamas in particular. With an estimated 4% of adults infected with HIV, the Bahamas has the highest annual incidence rate of AIDS in the English speaking Caribbean. In response, investigators from the United States and the Bahamian Ministry of Health/Princess Margaret Hospital developed and implemented a theory-based, face-to-face adolescent risk reduction intervention, "Focus on Youth in the Caribbean" (FOYC) which was found through two pilot-tests to significantly increase condom use among sexually active females two months post intervention and to alter the perceptions and intentions among males and females. Subsequently, in response to a request from the Bahamian Ministry of Health, the US-Bahamian research team developed a complementary parental intervention, "Caribbean Informed Parents and Children Together" (CImPACT) which was designed to improve parent-adolescent communication regarding safer-sex. Feasibility testing of CImPACT demonstrated that parents could be recruited and enrolled through the schools, would participate, and could be tracked longitudinally. During the pilot testing of both FOYC and CImPACT, relevant assessment instruments were validated for use in the Bahamas. Accordingly, this proposal seeks funding to conduct a three-cell controlled, randomized trial among 900 sixth grade adolescents (ages 11 to 13 at baseline) and their parents from 15 Bahamian elementary schools to assess the differential impact on adolescent risk behavior of: 1) an adolescent risk reduction intervention plus a parent control intervention (FOYC plus control); versus 2) a combined parent and adolescent risk reduction intervention (FOYC plus CImPACT); versus 3) an attention-control for youth and parents (control plus control) to assess both short-term (six months) and long-term (12, 18, 24, and 36 months) intervention effect. The primary outcome domain will be adolescent sexual risk behavior, including a) initiation of sex, b) sex without a condom and c) protected sex. Secondary outcome domains will be substance abuse, including tobacco, alcohol and drugs, and, two sets of mediating variables: a) youth perceptions of risk and protective behaviors organized by the constructs of the guiding model of behavioral change, Protection Motivation Theory; and, b) parent and adolescent perceptions of parental monitoring and parent-adolescent communication.