Engineering an Online STI Prevention Program

 描述（由申请人提供）：拟议研究的总体目标是减少大学生性传播感染（STI）的发病率。我们建议通过使用创新的，工程启发的多相优化策略（MOST）来实现这一目标，以开发一种高效，吸引人，经济，易于扩展的互联网交付的行为干预，针对酒精使用和性风险行为的交叉点。大学校园的性传播感染率令人担忧：四分之一的大学生在大学期间至少被诊断出一次性传播感染。饮酒时的性行为在大学生中非常普遍。众所周知，酒精的使用会导致危险的性行为，这些行为是性传播感染的最主要原因，即无保护的性行为、与众多伴侣接触和“勾搭”（随意的性接触）。很少有干预措施明确针对酒精使用和性风险行为的交叉点，没有一个得到优化。为了减少性传播感染在这一群体和其他高危群体中的传播，需要采取新的办法。MOST是一个全面的方法框架，它将工程原理的力量运用到行为干预的优化上。MOST使研究人员能够通过实验测试干预措施中的各个组成部分，以确定其有效性，并指出哪些组成部分需要修改和重新测试。鉴于大学生中饮酒和性行为的比例很高，大学环境为干预饮酒和性风险行为提供了理想的机会。拟议的研究将包括4个校区的大学生（约50%的非洲裔美国人）的多样化人口：2个历史上的黑人学院和大学，1个大型公立大学和1个大专。这 将增加我们发现的普遍性。我们的具体目标是：（1）开发和试点测试一套针对酒精使用和性风险行为之间联系的在线干预组件，（2）使用MOST方法建立优化的预防干预，（3）使用全功率RCT评估新优化的预防干预的有效性。这项工作将产生一种新的、更有效的行为干预措施，减少美国大学生中的性传播感染发病率，并为针对其他高危人群的新一代高效性传播感染预防干预措施奠定基础。

 DESCRIPTION (provided by applicant): The overall objective of the proposed research is to reduce the incidence of sexually transmitted infections (STIs) among college students. We propose to accomplish this by using the innovative, engineering-inspired multiphase optimization strategy (MOST) to develop a highly effective, appealing, economical, and readily scalable internet-delivered behavioral intervention targeting the intersection of alcohol use and sexual risk behavior. The rate of STIs on college campuses is alarming: one in four college students is diagnosed with an STI at least once during their college experience. Sexual activity when drinking alcohol is highly prevalent among college students. Alcohol use is known to contribute to the sexual risk behaviors that are most responsible for the transmission of STIs, namely unprotected sex, contact with numerous partners, and "hook- ups" (casual sexual encounters). Few interventions have been developed that explicitly target the intersection of alcohol use and sexual risk behaviors, and none have been optimized. In order to reduce the incidence of STI transmission among this and other high-risk groups, a new approach is needed. MOST is a comprehensive methodological framework that brings the power of engineering principles to bear on optimization of behavioral interventions. MOST enables researchers to experimentally test the individual components in an intervention to determine their effectiveness, indicating which components need to be revised and re-tested. Given the high rates of alcohol use and sex among college students, the college setting provides an ideal opportunity for intervening on alcohol use and sexual risk behaviors. The proposed study will include a diverse population of college students (˜ 50% African American) on 4 campuses: 2 Historically Black Colleges and Universities, 1 large public university, and 1 junior college. This will increase the generalizability of our findings. Our specific aims are to (1) develop and pilot test an initial set of online intervention components targeting the link between alcohol use and sexual risk behaviors, (2) use the MOST approach to build an optimized preventive intervention, and (3) evaluate the effectiveness of the newly optimized preventive intervention using a fully powered RCT. This work will result in a new, more potent behavioral intervention that will reduce the incidence of STIs among college students in the US, and will lay the groundwork for a new generation of highly effective STI prevention interventions aimed at other subpopulations at risk.