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

描述(申请人提供)：拉美裔青少年，特别是那些生活在波多黎各的青少年，感染艾滋病毒/艾滋病、其他性传播感染和意外怀孕的风险很高。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更多的支持，使青少年受益，并通过减少阻碍他们参与这些干预的障碍，增加父母对性健康的参与度。这项拟议的研究的目的是评估一个简短的、理论上知情的、文化上合适的、语言上量身定做的基于网络的父母沟通计划--“照顾他们”，旨在改善父母与青少年的性沟通，减少青少年的性风险行为。来自R21随机对照试验的最新发现表明，该计划增加了与讲英语和西班牙语的美国拉丁裔的亲子一般沟通和性风险沟通。7在这项拟议的研究中，我们计划通过改变基于网络的格式、增加与性沟通相关的内容数量和增加关于艾滋病毒/艾滋病污名的模块来修改铜？达洛斯干预措施。在这项随机对照研究中，我们将从波多黎各的社区机构招募父母(n=680)和他们的一名青少年(n=680)，并将被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。家长和青少年将在干预前以及3个月(仅限家长)、6个月和12个月的随访时完成测量。我们将针对以下五个具体目标：1)与一般的健康促进控制干预相比，在3个月、6个月和12个月的随访中，铜的DALOS干预是否增加了父母对与青少年的交流的舒适度以及与青少年的交流的数量，并减少了耻辱；2)与一般的健康促进控制干预相比，铜的DALOS干预是否减少了青少年的自我报告和无保护的性行为；3)基于理论的变量(态度、主观规范、感知行为控制、意图)是否中介了铜的DALOS对父母与青少年沟通的干预效果；(4)由个人(青少年：性经历、性别、年龄、耻辱；父母：性别、年龄、计算机使用/经历、参与计划的频率和时间)和微观系统(青少年：亲子沟通)变量调节的Cudalos干预措施对青春期性行为和亲子沟通的影响；(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，以及没有针对拉丁裔人的网上干预措施。如果程序是有效的，基于网络的格式将加速翻译 这项计划将对公共卫生实践和支持安全的青春期性健康行为作出重要贡献。干预是否具有成本效益？这项研究解决了在性健康结果方面存在的差异 公共卫生相关性：这项研究的结果将为父母和青少年提供重要的资源，以支持青少年的安全性行为决定。测试和使用基于网络的形式的结果将为为这一人群和其他未得到充分服务的人群制定未来的父母-青春期性风险降低方案和基于健康相关技术的干预措施提供重要信息。

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.