Recruiting, engaging & retaining families for interventions to prevent HIV transm

描述（由申请人提供）：本申请的目的是表明，通过加强家庭的招募、参与和保留，对有感染艾滋病毒风险的非裔美国青年（犯罪青少年）进行简短家庭干预的参与率和有效性可以得到显著加强。拟议的研究将利用“关心家庭：指导好的选择”（GGC）（又名“为无毒年做准备”）；一个简短有效的家庭干预，增加家庭联系，减少吸毒。我们将尝试通过制定一项增强协议来优化参与，解决与招聘、参与和保留有关的背景障碍。改进后的协议将包括给父母的励志DVD，一个励志招聘会议和一个家庭讲述他们的故事和描述他们当前家庭目标的预备会议。通过为非裔美国犯罪青少年及其家庭量身定制，GGC的有效性将进一步提高。这项研究将分为两个阶段。第一阶段将包括定制GGC和开发增强型协议。第二阶段将对60名目前在洛杉矶县教育办公室社区走读学校注册的非裔美国犯罪青少年及其父母（父母包括一名成年监护人）进行强化协议和GGC的试点测试。家庭（试用的非裔美国学生和他们的父母）将被随机分配到一个协议条件（增强协议/GGC或标准协议/GGC），并在3个月时进行监测。本研究的目的是：1.)制定一项增强的协议，以招募、吸引和留住在缓刑学校的非裔美国犯罪青少年及其父母；2.)通过定性焦点小组和关键信息提供者访谈，检查管理人员、教师、学生和家长对新人群（缓刑学校中的非裔美国犯罪青少年及其父母）的认知，以及GGC的适宜性；3)采用随机两组设计对增强方案和GGC进行试点测试，以评估增强方案在实现最佳招募、参与和保留方面的功效，并初步检验GGC在改善家庭功能、心理健康和问题行为（艾滋病毒风险行为、学校表现和再犯）方面的功效。

DESCRIPTION (provided by applicant): The goal of this application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of a brief family intervention for African American youth at risk for HIV infection - delinquent adolescents - can be significantly strengthened. The proposed study will utilize "Families that Care: Guiding Good Choices" (GGC) (aka "Preparing for the Drug Free Years"); a brief efficacious family intervention that increases family connectedness and decreases drug use. We will attempt to optimize participation by developing an enhanced protocol that addresses contextual barriers pertaining to recruitment, engagement and retention. The enhanced protocol will include a motivational DVD for parents, a motivational recruitment session and a pre-session for families to tell their stories and describe their current family goals. The efficaciousness of the GGC will be further increased by customizing it for use with African American delinquent adolescents and their families. The research will entail two phases. Phase 1 will encompass the tailoring of GGC and development of the enhanced protocol. Phase 2 will pilot test the enhanced protocol and GGC with 60 African American delinquent adolescents currently on probation who are enrolled in 6 Los Angeles County Office of Education's Community Day Schools and their parents (parents includes an adult guardian). Families (African American students on probation and their parents) will be randomly assigned to a protocol condition (enhanced protocol/GGC or standard protocol/GGC) and monitored at 3 months. The research aims are to: 1.) develop an enhanced protocol for recruiting, engaging and retaining African American delinquent adolescents in probation schools and their parents in GGC; 2.) examine the appropriateness of GGC for a new population (African American delinquent adolescents in probation schools and their parents) as perceived by administrators, teachers, students and parents through qualitative focus groups and key informant interviews; and 3.) pilot test the enhanced protocol and GGC using a randomized two groups design to evaluate the efficacy of the enhanced protocol in achieving optimal recruitment, engagement and retention, and preliminarily examine the efficacy of GGC to improve family functioning, mental health, and problem behaviors (HIV risk behaviors, school performance and recidivism). PUBLIC HEALTH RELEVANCE African Americans are at high risk for long-term negative, HIV-related outcomes (Anderson & Smith, 2005; Centers for Disease Control and Prevention, 2005; Shavers-Hornaday et al., 1997) as are delinquent adolescents on probation (Morris et al., 1995), and delinquent adolescents who cycle in and out of the juvenile justice system (Benda et al., 2001). Recent efforts that have achieved success suggest that individually focused prevention efforts need to be embedded within broader social contexts, such as the family system, to sustain behavior change (Lightfoot et al., 2006; Rotheram-Borus, 2005; Pequegnat et al., 2001; Boyd-Franklin et al., 2001).The goal of this R21 application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of an evidence based brief family intervention for African American youth at risk for HIV infection can be significantly strengthened.