Targeting HIV Risk Behaviors in Juvenile Drug Court-Involved Youth

针对涉及青少年毒品法庭的青少年的艾滋病毒危险行为

• 批准号: 7688641
• 负责人: Elizabeth J Letourneau
• 金额: $ 48.55万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-25 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7688641
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adolescent; Adopted; Adoption; Alcohol or Other Drugs use; Behavior; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinical Trials; Collaborations; Communities; Community Services; Cost Effectiveness Analysis; Counseling; Criminal Justice; Drug Courts; Drug abuse; Drug usage; Educational Intervention; Effectiveness; Effectiveness of Interventions; Enrollment; Evidence based practice; Evidence based treatment; Family; Follow-Up Studies; HIV; HIV Infections; HIV Seropositivity; Health Services Research; Human immunodeficiency virus test; Individual; Institution; Intervention; Knowledge; Label; Measures; Methods; Minority; Outcome; Pharmaceutical Preparations; Population; Preparation; Preventive Intervention; Protocols documentation; Randomized; Randomized Controlled Clinical Trials; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Risk; Risk Behaviors; Risk Reduction; Services; Sexually Transmitted Diseases; Societies; Staging; System; Testing; United States Public Health Service; Work; Youth; active method; adolescent substance abuse; base; community based treatment; contingency management; court; criminal behavior; critical period; design; effective intervention; emerging adulthood; evidence base; follow-up; health disparity; high risk; high risk sexual behavior; intervention effect; juvenile delinquent; offender; peer; protocol development; public health relevance; sex risk; therapy development; treatment effect

DESCRIPTION (provided by applicant): The overriding purpose of this study is to develop and test an intervention for reducing substance use and risky sexual behaviors among youth involved in juvenile drug court. Juvenile drug court provides an excellent setting in which to pursue the key study objectives by providing access to a well identified high risk population. Second, in addition to frequent judicial oversight, juvenile drug courts include several features that can enhance intervention effectiveness, sustainability, and potential for adoption. In addition, the fact that all juvenile drug courts have community-based treatment components and that such courts have been disseminated nationwide suggests the possibility of eventual widespread adoption if the proposed intervention is effective. The proposed intervention integrates evidence-based protocols for contingency management (CM) for substance abusing youth and family engagement strategies, with an evidence-informed family systems intervention for sexual risk originally developed to address substance use and sexual risk behaviors in HIV+ youth. These three interventions will be integrated into an efficient intervention that, if effective, can be amenable to adoption by juvenile drug courts. Following protocol development and beta testing, 160 drug court youth and their families will be randomized to the experimental intervention condition (HIV Risk Reduction or "HRR") versus Drug Court with Community Services (DC) conditions. Key outcomes will be assessed through 12-months post-baseline using a multi-method approach that will include assessment of substance use, risky sexual behaviors, criminal behavior, and participation in HIV counseling and testing services. Specific aims include: 1: Adapt existing intervention and training protocols into a single, efficient HRR intervention, beta test this HHR protocol with four youth in juvenile drug court and their families, and revise treatment and research protocols accordingly; 2: Conduct a randomized trial with 160 youth in juvenile drug court and their families to examine youth-level intervention effects (i.e., on substance use, sexual risk behavior, HIV counseling and testing, delinquent behavior) in comparison to DC through 12- months post referral and assess intervention fidelity. 3. If results suggest a positive HRR treatment effect, revise the intervention and training protocols in preparation for an effectiveness study and extended follow-up study. Importantly, the proposed study will (1) consider the multiple levels of influence on juvenile drug use, criminal justice involvement, and HIV risk behaviors, (2) integrate a drug abuse and HIV prevention intervention for youth in the criminal justice system with drug-related offenses, (3) address health disparities by targeting a primarily minority population of youth, and (4) increase referrals to HIV testing and counseling of drug court-involved youth. This study is designed to reduce HIV risk by addressing the potent interaction of drug use and risky sexual behaviors in drug court youth with evidence-based treatment components to maximize the likelihood of reversing these youths' adverse behavioral trajectories. PUBLIC HEALTH RELEVANCE: The proposed study is designed to gain knowledge about effective interventions for reducing HIV risk in a high risk population. Reducing HIV risk by effectively targeting substance use and risky sexual behaviors and by locating even a small number of HIV-positive youth could favorably impact society at multiple levels (individual, family, peer, community, fiscal).

描述（由申请人提供）：本研究的主要目的是开发和测试一种干预措施，以减少青少年毒品法庭中的物质使用和危险的性行为。青少年毒品法庭提供了一个很好的环境，通过提供接触明确确定的高风险人群的机会来实现关键研究目标。其次，除了频繁的司法监督外，青少年毒品法庭还包括一些可以提高干预有效性、可持续性和采用潜力的特点。此外，所有少年毒品法庭都有以社区为基础的治疗部分，而且这种法庭已在全国范围内传播，这一事实表明，如果拟议的干预措施有效，最终有可能被广泛采用。拟议的干预措施整合了以证据为基础的青少年药物滥用应急管理（CM）和家庭参与战略，以及一项以证据为基础的性风险家庭系统干预措施，该措施最初是为解决艾滋病毒阳性青少年的药物使用和性风险行为而制定的。这三种干预措施将纳入一项有效的干预措施，如果有效，可以由少年毒品法庭采用。在协议制定和beta测试之后，160名毒品法庭青少年及其家人将被随机分配到实验干预条件（艾滋病毒风险降低或“HRR”）和社区服务条件（DC）的毒品法庭。将在基线后12个月内采用多方法评估主要结果，其中包括评估药物使用情况、危险性行为、犯罪行为以及参与艾滋病毒咨询和检测服务。具体目标包括：1：将现有的干预和培训方案调整为单一的、有效的HRR干预，在青少年毒品法庭的四名青少年及其家人中对该HHR方案进行beta测试，并相应地修改治疗和研究方案；2：在青少年毒品法庭对160名青少年及其家庭进行随机试验，通过转介后12个月，与DC相比，检查青少年层面的干预效果（即在药物使用，性风险行为，艾滋病毒咨询和检测，犯罪行为方面），并评估干预的保真度。3. 如果结果显示积极的HRR治疗效果，修改干预和训练方案，为有效性研究和延长随访研究做准备。重要的是，该研究将(1)考虑对青少年吸毒、刑事司法介入和艾滋病毒风险行为的多重影响，(2)将毒品相关犯罪的青少年纳入刑事司法系统的药物滥用和艾滋病毒预防干预，(3)通过主要针对少数群体的青少年来解决健康差距，(4)增加对毒品法庭涉事青少年的艾滋病毒检测和咨询的转介。本研究旨在通过以证据为基础的治疗成分来解决毒品法庭青年中药物使用和危险性行为的有效相互作用，从而最大限度地扭转这些青年的不良行为轨迹，从而降低艾滋病毒风险。