Testing a Latino web-based parent-adolescent sexual communication intervention

描述（由申请人提供）：拉丁裔青少年，特别是那些生活在波多黎各的青少年，是艾滋病毒/艾滋病，其他性传播感染（STIs）和意外怀孕的高危人群。基于网络的父母沟通干预提供了一个机会，通过为更安全的性行为决定提供额外支持，使青少年受益，并通过减少阻止父母参与这些干预的障碍，增加父母对性健康的参与。本研究的目的是评估一个简短的、理论上知情的、文化上适当的、语言上量身定制的基于网络的父母交流项目Cu¿dalos（“照顾他们”），该项目旨在改善父母与青少年的性交流，减少青少年的性风险行为。最近，一项R21随机对照试验对基于计算机的Cu¿dalos项目进行了简短的测试，结果表明，该项目增加了与说英语和西班牙语的美国拉丁裔人的父母-青少年一般交流和性风险交流。7在这项拟议的研究中，我们计划修改Cu¿dalos干预措施，将其改为基于网络的格式，增加与性交流相关的内容数量，并增加一个关于艾滋病毒/艾滋病耻辱的模块。在这项随机对照试验中，我们将从波多黎各社区机构招募父母（n=680）和他们的一名青少年（n=680），并将随机分配接受基于父母的Cu¿dalos干预或基于网络的健康促进控制条件。父母和青少年将在干预前和3个月（仅限父母）、6个月和12个月的随访中完成措施。我们将解决以下五个具体目标：1)与一般健康促进控制干预相比，Cu¿dalos干预是否在3个月、6个月和12个月的随访中增加了父母与青少年沟通的舒适度和数量，并减少了耻辱感；2)与一般健康促进控制干预相比，Cu¿dalos干预是否减少了青少年自我报告的性行为和无保护的性行为；3)基于理论的变量（态度、主观规范、感知行为控制、意向）是否在Cu¿dalos对父母与青少年沟通的干预作用中起中介作用？4) Cu¿dalos干预对青少年性行为和亲子沟通的影响是否受到个体变量（青少年：性经验、性别、年龄、污名；父母：性别、年龄电脑使用/经验、参与项目的频率和时间）和微系统变量（青少年：亲子沟通）的调节？5)波多黎各和拉丁裔青年，缺乏针对拉丁裔父母和青少年的文化和语言上有效的干预措施，以及缺乏针对拉丁裔的网络干预措施。如果程序是有效的，基于网络的格式将加速翻译

DESCRIPTION (provided by applicant): Latino adolescents, especially those living in Puerto Rico, are at high risk for HIV/AIDS, other sexually transmitted infections (STIs), and unintended pregnancies. A web-based parent communication intervention provides an opportunity to benefit adolescents by providing additional support for safer sex decisions, and to increase parents' involvement in sexual health by decreasing barriers that keep them from participating in these interventions. The purpose of this proposed study is to evaluate a brief, theoretically informed, culturally appropriate, and linguistically tailored web-based parental communication program, Cu¿dalos ("Take care of them"), designed to improve parent-adolescent sexual communication and reduce adolescent sexual risk behavior. Recent findings from an R21 RCT testing a brief computer-based version of the Cu¿dalos program indicated that the program increased parent-adolescent general communication and sexual risk communication with English and Spanish speaking U.S. Latinos.7 In this proposed study, we plan to modify the Cu¿dalos intervention by changing to a web-based format, increasing the amount of content related to sexual communication and adding a module on HIV/AIDS stigma. In this RCT, we will recruit parents (n=680) and one of their adolescents (n=680) from community-based agencies in Puerto Rico, and will be randomly assigned to receive either the parent-based Cu¿dalos intervention or a web-based health promotion control condition. Parents and adolescents will complete measures at pre-intervention and at 3-(parents only), 6-, and 12-month follow-ups. We will address the five following specific aims: 1) Does the Cu¿dalos intervention increase parents' comfort with, as well as the amount of, communication with adolescents and decrease stigma at 3-,6-, and 12- month follow-ups as compared to the general health promotion control intervention; 2) Does the Cu¿dalos intervention decrease self-reported adolescent intercourse and unprotected intercourse at the follow-ups as compared to the general health promotion control intervention; 3) Do theory-based variables (attitudes, subjective norms, perceived behavioral control, intentions) mediate the intervention effects of Cu¿dalos on parents' communication with their adolescents; 4) Are the effects of the Cu¿dalos intervention on adolescent sexual behavior and parent-adolescent communication moderated by individual (adolescents: sexual experience, gender, age, stigma; parents: gender, age computer access/experience, frequency and time engaged in the program), and microsystem (adolescents: parent-adolescent communication) variables; and 5) Puerto Rican and Latino youth, the lack of culturally and linguistically effectiv interventions for Latino parents and adolescents, and the absence of web-based interventions for Latinos. If the program is efficacious, the web-based format will accelerate the translation of this program into public health practice and will be an important contribution in supporting safe adolescent sexual health behaviors. Is the intervention cost-effective? This study addresses existing disparities in sexual health outcomes among PUBLIC HEALTH RELEVANCE: Results from this study will provide an important resource to parents and adolescents to support adolescents' safer sex decisions. Results from testing and using a web-based format will provide important information for the development of future parent-adolescent sexual risk reduction programs and health related technology based interventions for this and other underserved populations.