Evidence-based sexual and reproductive health intervention using a multiphase optimization strategy

使用多阶段优化策略进行循证性健康和生殖健康干预

• 批准号: 10253629
• 负责人: Katherine Gannett Merrill
• 金额: $ 14.38万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-11 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10253629
• 关键词: 18 year old; AIDS/HIV problem; Acculturation; Address; Adolescent; Adult; Affect; African American; Award; Awareness; Behavior Therapy; Biological; Chicago; Chlamydia; Communities; Competence; Control Groups; Data Collection; Daughter; Development; Educational workshop; Effectiveness; Effectiveness of Interventions; Evidence based intervention; Evidence based program; Faculty; Family; Feedback; Female Adolescents; Focus Groups; General Population; Goals; Gonorrhea; Grant; Health; Health Promotion; Home environment; Incidence; Individual; Infection; Intervention; Knowledge; Language; Latina; Learning; Link; Literature; Measures; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Methodology; Methods; Mothers; Outcome; Parents; Phase; Population Heterogeneity; Positioning Attribute; Pregnancy in Adolescence; Preparation; Process; Publishing; Randomized Controlled Trials; Reading; Religion; Research; Research Design; Research Personnel; Risk; Running; Scientist; Sexual Health; Sexually Transmitted Diseases; Shapes; South African; Syphilis; Testing; Training; Translating; Trichomonas; United States; Youth; adolescent health; adolescent health outcomes; adolescent sexual behavior; adverse outcome; base; behavioral outcome; career; community based participatory research; contextual factors; design; driving force; effectiveness evaluation; emotion regulation; evidence base; experience; experimental study; girls; health disparity; high risk; high risk sexual behavior; implementation science; innovation; interest; intervention mapping; intimate partner violence; meetings; multiphase optimization strategy; peer; primary outcome; programs; reproductive health intervention; scale up; secondary outcome; sexual health intervention; substance use; symposium; tenure track; theories; tool

ABSTRACT Latina adolescents in the U.S. are disproportionately affected by HIV/AIDS/sexually-transmitted infections (STIs) and other adverse consequences of risky sexual behavior. The home environment is recognized to shape adolescents' health outcomes, but only one Latina mother-daughter sexual health program was identified in the literature. IMARA (Informed, Motivated, Aware, and Responsible Adolescents and Adults) is an evidence-based intervention for African American adolescent girls and their mothers, which is well-suited to be adapted for Latinas. In a randomized controlled trial (RCT) in Chicago, the program reduced the risk of new STIs by 45% compared to the control group among 14-18-year-olds. In this K99/R00 award, I propose to adapt IMARA to a Latina audience and pilot an optimization trial within community-based organizations (CBOs) in Chicago, using the multiphase optimization strategy (MOST). MOST is a methodological framework for developing an optimal intervention package by assessing the effectiveness of an intervention's components prior to subjecting the intervention to an RCT. This grant focuses on the preparation phase of MOST, using an implementation science (IS) approach and drawing on community-based participatory research (CBPR) principles to pursue three specific aims: 1) adapt the intervention for Latinas by establishing a community advisory board and engaging 12 mother-daughter dyads in 4 focus group discussions (K99 phase); 2) establish the acceptability, feasibility, and appropriateness of the intervention components through piloting among 24 new dyads (K99 phase); and 3) pilot an optimization trial of the adapted intervention among 92 new dyads and examine intervention component effects on risky sexual behavior (primary outcome) and STI incidence (secondary outcome) (R00 phase). These research aims will allow me to build on my strong research and publishing experience in adolescent health and capitalize on the expertise of my mentorship team in sexual risk interventions for youth to achieve four training aims, to: 1) gain knowledge in CBPR principles and their application; 2) develop expertise in IS theory/design and its application; 3) learn to employ innovative research designs, analysis strategies, and frameworks for behavioral interventions, including MOST; and 4) further my professional development to obtain a tenure-track faculty position prior to the R00 phase. I will accomplish my training aims through meetings, directed readings, and conference/workshop attendance, with support from my mentors (Primary Mentor: Geri Donenberg). Findings will form the basis of an R01 application for a fully-powered optimization trial to test intervention component impacts on STI incidence among Latina adolescents. The long-term goal is to generate an efficient, sustainable adapted intervention with potential for scale-up with CBOs serving Latinas. This K99/R00 award will give me a platform on which to launch my career as an independent adolescent health researcher, specialized in innovative methods for developing, implementing, and evaluating behavioral interventions.

摘要 美国的拉丁裔青少年受艾滋病毒/艾滋病/性传播感染的影响不成比例 （性传播感染）和其他不良后果的危险性行为。家庭环境被认为是 塑造青少年的健康结果，但只有一个拉丁裔母女性健康计划是 在文献中发现。IMARA（知情，动机，意识和负责任的青少年和成人）是一个 对非洲裔美国少女及其母亲进行循证干预，这非常适合 适合拉丁人。在芝加哥的一项随机对照试验（RCT）中，该项目降低了新的 与对照组相比，14-18岁青少年的性传播感染率降低了45%。在这个K99/R 00奖项中，我建议 使IMARA适应拉丁裔受众，并在社区组织内进行优化试验 （CBO）在芝加哥，使用多相优化策略（MOST）。MOST是一种方法论 通过评估干预措施的有效性， 在对干预进行随机对照试验之前，该补助金侧重于准备阶段， 社会变革管理计划（MOST），采用实施科学（IS）方法，并利用社区参与式 研究（CBPR）原则，追求三个具体目标：1）通过建立适应拉丁美洲的干预措施， 一个社区咨询委员会，并让12对母女参加4次焦点小组讨论（K99 阶段）; 2）通过以下方式确定干预组件的可接受性、可行性和适当性： 在24个新的二元组（K99期）中进行试点; 3）在以下人群中进行适应性干预的优化试验： 92个新的二元组，并检查干预成分对危险性行为的影响（主要结局）， STI发生率（次要结局）（R 00阶段）。这些研究目标将使我能够建立在我的强大 研究和出版青少年健康的经验，并利用我的导师的专业知识 青少年性风险干预小组，以实现四个培训目标，以：1）获得CBPR知识 原则及其应用; 2）发展信息系统理论/设计及其应用的专业知识; 3）学会使用 创新的研究设计、分析战略和行为干预框架，包括社会变革管理计划; 和4）进一步我的专业发展，以获得终身教职之前，R 00阶段。我 将通过会议、指导性阅读和参加会议/研讨会来实现我的培训目标， 在我的导师的支持下（主要导师：Geri Donenberg）。调查结果将构成R 01的基础 申请进行全面优化试验，以测试干预成分对STI发病率的影响 在拉丁裔青少年中。长期目标是产生一种有效的、可持续的适应性干预措施， 有可能扩大社区组织为拉丁美洲人服务的规模。K99/R 00奖将为我提供一个平台， 开始我的职业生涯作为一个独立的青少年健康研究员，专门从事创新方法 用于开发、实施和评估行为干预。