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

描述（由申请人提供）：拉丁美洲青少年，特别是那些生活在波多黎各，是在艾滋病毒/艾滋病，其他性传播感染（性病）和意外怀孕的高风险。基于网络的家长沟通干预措施提供了一个机会，通过为更安全的性行为决定提供额外的支持，使青少年受益，并通过减少阻碍家长参与这些干预措施的障碍，增加家长对性健康的参与。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，和语言量身定制的基于网络的父母沟通计划，Cu <$dalos（“照顾他们”），旨在改善父母与青少年的性沟通，减少青少年的性风险行为。最近的一项R21随机对照试验（RCT）测试了一个简短的基于计算机的Cu <$dalos程序版本，结果表明，该程序增加了父母与青少年的一般沟通以及与讲英语和西班牙语的美国拉丁裔的性风险沟通。通过改为网络格式，增加与性交流有关的内容数量，并增加一个关于艾滋病毒/艾滋病污名化的模块，加强了dalos干预措施。在这项随机对照试验中，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。父母和青少年将在干预前和3个月（仅限父母）、6个月和12个月随访时完成测量。我们将讨论以下五个具体目标：1）与一般健康促进控制干预相比，Cu？dalos干预是否增加了父母与青少年沟通的舒适度以及沟通量，并在3个月、6个月和12个月的随访中减少了耻辱感; 2）Cu？dalos干预是否增加了父母与青少年沟通的舒适度以及沟通量，并在3个月、6个月和12个月的随访中减少了耻辱感。与一般健康促进控制干预相比，dalos干预减少了随访时自我报告的青少年性交和无保护性交; 3）基于理论的变量（态度、主观规范、知觉行为控制、意图）在家长与青少年沟通中起中介作用; 4）家长与青少年沟通对青少年性行为和亲子沟通的干预效果是否受个体的调节（青少年：性经验，性别，年龄，耻辱;父母：性别，年龄计算机访问/经验，频率和时间从事程序），和微系统（青少年：父母-青少年沟通）变量;和5）波多黎各和拉丁美洲青年，缺乏对拉丁美洲父母和青少年的文化和语言有效干预，以及缺乏针对拉丁裔的网络干预措施。如果该计划是有效的，基于网络的格式将加快翻译， 这一方案将纳入公共卫生实践，并将为支持安全的青少年性健康行为做出重要贡献。干预是否具有成本效益？这项研究解决了现有的性健康结果之间的差异，

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