Web-Based Substance Abuse STD/HIV Prevention

描述（由申请人提供）：目前的预防工作，以减少艾滋病毒/性传播疾病的风险在青少年中已显示出一定的效果，但更有效，更容易传播的干预措施仍然需要开发和仔细评估。与此同时，先前对媒体和课堂预防干预的研究表明，设计得更新颖和更具参与性的干预措施在改变一些关键的青少年健康风险行为方面更有效。针对青少年健康行为量身定制的网络计划的有效性进行的研究表明，通过包括专门设计的元素来吸引，保持注意力，并说服那些最有可能处于危险之中的人，行为得到了成功的改变。这些高度互动、生动、快节奏的刺激可能有效地引起本研究项目感兴趣人群的注意：那些最有可能冒险增加艾滋病毒/性病暴露可能性的人。我们的目标是：（1）将成功的性风险行为预防课程改编为自我管理的网络课程，以不同的信息针对高感觉寻求和低感觉寻求的青少年;（2）在高中早期环境中实施示范方案;评估干预对青少年保持禁欲意愿变化的影响，避免在性行为前使用药物，并在阴道或肛门性交时使用避孕套。其他评估包括知识，艾滋病毒/性传播疾病的显着性，感染艾滋病毒/性传播疾病的感知风险，自我效能的技能，保持禁欲，协商安全的性行为，使用避孕套。该网站的干预措施将促进尚未开始性行为的青年禁欲，并促进正在发生性行为和打算继续发生性行为的人使用安全套和其他安全性行为，以实现预防/减少青年中艾滋病毒/性传播疾病传播的目标。为实现这些目标，提出了一个分两个阶段的项目。第一阶段（1-2年级）将涉及通过重点小组和反应小组制定干预措施，这些小组帮助改进问题，设计有效的课程材料，以及在互联网环境下制作和编制多媒体节目。利用以前基于互联网的预防研究开发的软件引擎，艾滋病毒/性病预防方案将为尚未性活跃的学生提供延长禁欲期的信息，并为性活跃的学生提供增加安全套使用和减少其他危险性行为的信息。基于互联网的计划将在项目的第二阶段（3-5年级）实施和评估，采用分组随机的前后测控制组设计，以阿尔伯克基和丹佛的公立学校为分析单位。干预对艾滋病毒/性病预防技能，行为意向和性冒险行为的影响将在三个后续的后测试（在完成干预，6个月后，1年后）进行评估。研究的最后一年将涉及最终数据分析和现场试验结果。公共卫生相关性：艾滋病毒和性传播疾病感染率以及青少年，特别是少数民族青少年过早发生性行为的相关负面后果，仍然是预防研究人员关注的问题。酒精的使用也明显与性活动的早期开始相关，并可能以复杂的方式与性冒险有关。通过结合研究计划和专业知识，在制作预防性媒体信息为高感觉寻求者，采用信息曝光和感觉寻求原则，并利用我们的专业知识，在开发和测试多媒体预防网站，我们将开发一个艾滋病毒/性病和酒精预防网站的青少年，将量身定制的青少年用户的感觉寻求的水平。因此，将制定的网站干预措施将以经经验验证的预防原则为基础，一旦确定网站的功效，就有可能迅速和广泛地传播。

DESCRIPTION (provided by applicant): Current prevention efforts to curtail HIV/STD risk among adolescents has shown some efficacy, but interventions that are both more effective and more easily diffused still need to be developed and carefully evaluated. At the same time, prior research on media and classroom preventive interventions has shown that interventions designed to be more novel and participatory are more effective in altering a number of crucial adolescent health risk behaviors. Research examining the effectiveness of tailored web-based programs on adolescent health behaviors have demonstrated that behaviors were successfully changed by including elements designed specifically to attract, hold the attention of, and persuade those most likely at risk. These highly interactive, vivid, quickly-paced stimuli may be effective in eliciting the attention of the population-of- interest for this research project: those most likely to take risks that increase the likelihood of HIV/STD exposure. Our objectives are to 1) adapt the successful sexual risk behavior prevention curricula to a self- administered Web-based curriculum that will target high sensation-seeking and low sensation-seeking youth with separate messages; 2) implement the model program in the early high school environment; and 3) evaluate the effect of the intervention on the change in adolescents' intentions to remain abstinent from sexual intercourse, to avoid the use of drugs before sex and to use condoms for vaginal or anal intercourse. Other evaluations include knowledge, salience of HIV/STD, perceived risk of contracting HIV/STD, and self-efficacy skills related to remaining abstinent, negotiating safe sexual behavior, and using condoms. The website intervention will promote abstinence among youth who have not yet started having sex and promote condom use and other safe-sex practices among those who are engaging in sex and intend to continue for the goal of prevention/reduction of HIV/STD transmission among youth. A two-phase project is proposed to address these aims. The first phase (Years 1-2), will involve intervention development through focus and reaction groups that help refine issues and design effective curricular materials and multimedia production and programming in the Internet environment. Using a software engine developed in previous Internet-based prevention research, the HIV/STD prevention program will tailor messages intended to prolong sexual abstinence for students who are not yet sexually active and messages to increase condom use, and reduce other risky sexual behaviors for those who are sexually active. The Internet- based program will be implemented and evaluated in the second phase of the project (Years 3-5) using a group-randomized pretest-posttest control group design, with public schools in Albuquerque and Denver as the unit of analysis. The impact of the intervention on HIV/STD prevention skills, behavioral intentions, and sexual risk-taking behaviors will be assessed in three follow-up posttests (at completion of the intervention, 6-month post, and at 1-year post). The final year of the study will involve final data analysis and field trial outcomes. PUBLIC HEALTH RELEVANCE: The rate of HIV and STD infection as well as related negative consequences of early onset of sexual behavior among adolescents, especially minority adolescents, continues to be a concern for prevention researchers. Alcohol use is also clearly a correlate of early initiation of sexual activity and may be related in complex ways to sexual risk-taking. By combining research programs and expertise in crafting preventive media messages for high sensation seekers, employing information exposure and sensation seeking principles, and utilizing our expertise in developing and testing multimedia prevention websites, we will develop a HIV/STD and alcohol prevention website for adolescents that will be tailored to the adolescent user's level of sensation seeking. As a result, the website intervention to be developed will be grounded in empirically verified prevention principles, and will have the potential to be quickly and widely disseminated once the efficacy of the website has been determined.