Enhancing Message Design in Tailored Computerized HIV/STI Interventions

描述（由申请人提供）：拟议的研究将包括开发和试点测试一个交互式计算机定制干预程序，用于在18-44岁的异性恋活跃的非洲裔性病临床患者中预防艾滋病毒/性病。态度-社会-影响效能模型将作为干预和定制反馈的概念基础，该模型将分别对主要/稳定伴侣和其他/临时伴侣的参与者进行评估并给予反馈。单个模块将针对关键的理论概念进行开发，然后将它们捆绑在一起，形成一个完整的系统。量身定制的反馈还将通过精心制作具有高信息感知价值的干预信息，以及开发以社会认知理论和技能培训原则为指导的技能培养互动干预活动来增强。将利用从目标受众收集的数据制定和指导计算机化干预措施，以确保以经验为基础的量身定制方法。干预措施也将根据目标受众的输入来制定，以便最大限度地提高反馈和方案的适当性和说服力，包括互动部分。该项目的最后一年将需要对干预措施进行试点测试，以便收集初步数据，了解这种干预措施的可接受性和有效性，以提高处于危险中的异性恋活跃的非裔美国人的安全性行为。本研究的具体目的是：1)基于ASE模型，开发针对HIV/STI预防的个性化反馈，包括安全套态度、社会影响、自我效能感（包括沟通/谈判技巧）、伴侣和行为风险、正确使用安全套以及安全套变化阶段；2)在社会认知理论（SCT）和技能训练原则的指导下，利用感觉寻求目标（SENTAR）和互动活动来加强定制信息的传递；3)将各个理论模块结合在一起，制定艾滋病毒/性传播感染预防的计算机干预方案，根据参与者的特征评估，为参与者提供量身定制的降低风险信息；4)针对目标受众，开发经验上合理的切入点，指导信息裁剪；5)在等待名单控制组设计中，相对于“常规护理”的比较条件，对在异性恋活跃的高危非洲裔美国人中增加主要伴侣和临时伴侣使用避孕套的干预的可接受性和有效性进行试点测试。目前的应用与公共卫生有关，因为它侧重于在高危群体，即非洲裔美国人中预防艾滋病毒/艾滋病。该应用程序旨在开发和评估一个基于计算机的程序，以帮助来到性传播疾病诊所的非裔美国人采取更安全的性行为。

DESCRIPTION (provided by applicant): The proposed study will involve the development and pilot testing of an interactive computerized tailored intervention program for HIV/STI prevention among at-risk heterosexually active African-American STI clinic patients, aged 18-44. The Attitude-Social-Influence Efficacy model will serve as a conceptual foundation for the intervention and tailored feedback, which will assess and give feedback to participants separately for main/steady and other/casual partners. Individual modules will be developed for key theoretical concepts and subsequently tied together into an integrated system. The tailored feedback will additionally be enhanced by crafting intervention messages to be high in message sensation value and by developing interactive intervention activities for skill-building, which will be guided by both Social Cognitive Theory and skills training principles. The computerized intervention will be developed and guided using data collected from the target audience to ensure an empirically-based approach to tailoring. The intervention will also be developed with input from the target audience in order to maximize the appropriateness and persuasiveness of the feedback and the program, including interactive components. The final year of the project will entail a pilot test of the intervention in order to gather preliminary data on the acceptability and efficacy of such an intervention for increasing safer sexual behaviors among at-risk heterosexually active African- Americans. The specific aims of the study are: 1) to develop tailored feedback on HIV/STI prevention based on the ASE model, including condom attitudes, social influences, self-efficacy including communication / negotiation skills, partner and behavioral risk, correct condom use, and condom stages of change; 2) to enhance the delivery of the tailored messages using sensation- seeking targeting (SENTAR) and skill-building using interactive activities guided by Social Cognitive Theory (SCT) and skills training principles; 3) to tie the individual theoretical modules together and develop a computerized intervention program for HIV/STI prevention, which provides tailored risk reduction messages to participants based upon an assessment of participant characteristics; 4) to develop empirically sound cutpoints, specific to the target audience, to guide the message tailoring; and 5) in a wait-list control group design, to pilot test the intervention for acceptability and efficacy in increasing condom use with main and casual partners among at-risk heterosexually active African-Americans, relative to a "usual care" comparison condition. The current application is relevant to public health because it focuses on preventing HIV/AIDS in a high-risk group, namely African-Americans. The application aims to develop and evaluate a computer-based program to help African-Americans who come to a sexually transmitted disease clinic adopt safer sex practices.